| Doctor Name: | MARK MCGOWAN |
| NPI Number: | 1023476298 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | RN175625 |
| Business Practice Address: | Hwy 160/163 Bldg Ka2010 Kayenta, AZ - 860330368 |
| Business Phone Number: | 9286974000 |
| Business Fax Number: | |
| Mailing Address: | Hwy 160/163 Bldg Ka2010, KAYENTA |
| State: | AZ |
| Postal Code: | 860330368 |
| Phone Number: | 9286974000 |
| Fax Number: | |
| NPI Enumeration Date: | 02/03/2016 |
| NPI Last Update Date: | 02/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WE0003X |
| License Number: | RN175625 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Emergency |
| Taxonomy Definition: | |