Healthcare Provider Details

I. General information

NPI: 1871589960
Provider Name (Legal Business Name): BRENDON J HOVEST C.N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 10/12/2024
Certification Date: 10/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 STATE ROUTE 224 SUITE 2
OTTAWA OH
45875-9239
US

IV. Provider business mailing address

PO BOX 636930
CINCINNATI OH
45263-0001
US

V. Phone/Fax

Practice location:
  • Phone: 419-538-7330
  • Fax: 419-538-7331
Mailing address:
  • Phone: 419-538-7330
  • Fax: 419-538-7331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.07031
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: