MR. PAUL A GOBOURNE CRNP NPI 1245417492

NPI Information

NPI: 1245417492
Provider Name: MR. PAUL A GOBOURNE, CRNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
8901 WISCONSIN AVE
BLDG. 8 RM 3169C
BETHESDA, MD
ZIP 20889
Phone: (301) 400-1012
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MR. Paul A Gobourne, CRNP is a family nurse practitioner in Bethesda, MD with 21 years of experience. MR. Paul A Gobourne, CRNP NPI is 1245417492. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8901 WISCONSIN AVE
BLDG. 8 RM 3169C
BETHESDA, MD
ZIP 20889-600
Phone: (301) 400-1012
Fax: (301) 295-8963

The NPI 1245417492 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/29/2008 and was last updated on 3/2/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	RN965066	DISTRICT OF COLUMBIA	No
2	363LF0000X	Nurse Practitioner	Family	R132556	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	Q14873	MEDICARE UPIN
2	G01934F01	MEDICARE PIN	DISTRICT OF COLUMBIA
3	035904300	MEDICAID	DISTRICT OF COLUMBIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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