Provider Demographics
NPI:1710710181
Name:MCGOUGH, JADA
Entity type:Individual
Prefix:
First Name:JADA
Middle Name:
Last Name:MCGOUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1479 WINDWARD WAY APT 102
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49444-7818
Mailing Address - Country:US
Mailing Address - Phone:231-531-1667
Mailing Address - Fax:
Practice Address - Street 1:1479 WINDWARD WAY APT 102
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49444-7818
Practice Address - Country:US
Practice Address - Phone:231-531-1667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula