Healthcare Provider Details

I. General information

NPI: 1487872107
Provider Name (Legal Business Name): NADINE THERESA HOVEN RN, CNS, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4135 RICHARD AVE STE 201
HERMANTOWN MN
55811-2979
US

IV. Provider business mailing address

4135 RICHARD AVE STE 201
HERMANTOWN MN
55811-2979
US

V. Phone/Fax

Practice location:
  • Phone: 218-591-9126
  • Fax:
Mailing address:
  • Phone: 218-591-9126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberR167986-7
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3645
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: