| NPI | 1295615615 |
|---|---|
| Former Name | COLLEEN MCGOVERN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2025038585) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5385148) |
| Enumeration Date | 2025-09-05 |
| Last Update Date | 2026-02-17 |