Healthcare Provider Details

I. General information

NPI: 1578713301
Provider Name (Legal Business Name): BRANDY ROSE HOVEST R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 09/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3626 ROAD H
LEIPSIC OH
45856-9713
US

IV. Provider business mailing address

3626 ROAD H
LEIPSIC OH
45856-9713
US

V. Phone/Fax

Practice location:
  • Phone: 419-943-7522
  • Fax:
Mailing address:
  • Phone: 419-943-7522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN 293791
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: