Healthcare Provider Details

I. General information

NPI: 1629208368
Provider Name (Legal Business Name): STEPHANIE MARIE HOVE ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 11/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 S FREMONT AVE STE 5000
SPRINGFIELD MO
65804-2239
US

IV. Provider business mailing address

PO BOX 2580
SPRINGFIELD MO
65801-2580
US

V. Phone/Fax

Practice location:
  • Phone: 417-820-3960
  • Fax:
Mailing address:
  • Phone: 417-829-4620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number2013021224
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: