Healthcare Provider Details

I. General information

NPI: 1578111696
Provider Name (Legal Business Name): AMANDA DAWN BOVEE CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2019
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 W MAIN ST
ANDOVER OH
44003-9318
US

IV. Provider business mailing address

604 W 57TH ST
ASHTABULA OH
44004-7114
US

V. Phone/Fax

Practice location:
  • Phone: 216-800-8700
  • Fax: 216-353-4804
Mailing address:
  • Phone: 440-228-9226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.025157
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.025157
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: