Healthcare Provider Details

I. General information

NPI: 1346802766
Provider Name (Legal Business Name): STEVEN HOVERMALE FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: STEVEN HOVERMALE FNP

II. Dates (important events)

Enumeration Date: 07/05/2019
Last Update Date: 11/03/2020
Certification Date: 11/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 FOXGLOVE DR STE D
MOUNT STERLING KY
40353-9735
US

IV. Provider business mailing address

1056 TWIN OAKS BLVD
MOUNT STERLING KY
40353-7000
US

V. Phone/Fax

Practice location:
  • Phone: 859-498-3333
  • Fax: 859-498-3332
Mailing address:
  • Phone: 606-336-1380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1134462
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3013599
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: