Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | OS017591 | PA |
NPI | 1003136375 |
---|---|
Provider Name | Lindsey Marie Govern |
First Address | Harrisburg, PA 17104-1612 |
Second Address | Harrisburg, PA 17109-4839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2010 |
Last Update Date | 02/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103048940 | (05) | PA |