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NPI Code Detail

MEDICARE: SHAQUNNA MCGOWAN CCSS

MEDICARE: SHAQUNNA MCGOWAN CCSS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1841121357
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAQUNNA MCGOWAN CCSS
Provider Business Mailing Address
First Line : 3450 HIGHWAY 80 W
Second Line :
City : JACKSON
State : MS
Zip : 39209-7201
Country : US
Telephone Number : 601-321-2449
Fax Number :
Provider Business Practice Location Address
First Line : 3450 HIGHWAY 80 W
Second Line :
City : JACKSON
State : MS
Zip : 39209-7201
Country : US
Telephone Number : 601-321-2449
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2026
Last Update Date : 05/26/2026

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Directions to “ SHAQUNNA MCGOWAN CCSS” Practice Location

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