Healthcare Provider Details

I. General information

NPI: 1033446422
Provider Name (Legal Business Name): JANE L OVEDOVITZ R.N.,F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2009
Last Update Date: 02/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7955 TUCKERMAN LANE
ROCKVILLE MD
20854
US

IV. Provider business mailing address

7955 TUCKERMAN LN
ROCKVILLE MD
20854-3243
US

V. Phone/Fax

Practice location:
  • Phone: 646-242-7404
  • Fax:
Mailing address:
  • Phone: 646-242-7404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR164557
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License NumberR164557
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberRN1006369
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: