Provider Demographics
NPI:1861727893
Name:MCGOVERN, KATHY PICHEL (CRNP)
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:PICHEL
Last Name:MCGOVERN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 UNIVERSITY DRIVE
Mailing Address - Street 2:JOHNSON HALL
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015
Mailing Address - Country:US
Mailing Address - Phone:610-758-3870
Mailing Address - Fax:610-758-5833
Practice Address - Street 1:36 UNIVERSITY DRIVE
Practice Address - Street 2:JOHNSON HALL
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015
Practice Address - Country:US
Practice Address - Phone:610-758-3870
Practice Address - Fax:610-758-5833
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN269898L163W00000X
PAVP004198B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse