Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | CNP191194 | ME |
Y | 363LA2100X | Nurse Practitioner - Acute Care | 072788-23 | NH |
NPI | 1043680853 |
---|---|
Provider Name | Jennifer Winthrop Golkowski |
First Address | North Conway, NH 03860-7101 |
Second Address | North Conway, NH 03860-7101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2015 |
Last Update Date | 09/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5103273 | (05) | NH |