Healthcare Provider Details

I. General information

NPI: 1467322727
Provider Name (Legal Business Name): JEANETTE KOVACH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 E MAIN ST
SPRING ARBOR MI
49283-9701
US

IV. Provider business mailing address

2050 LEXINGTON RD
VERSAILLES KY
40383-1738
US

V. Phone/Fax

Practice location:
  • Phone: 517-750-6684
  • Fax:
Mailing address:
  • Phone: 859-251-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN712732
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: