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General NPI Number Information
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NPI Number | 1891872933
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Entity Type | Individual
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Provider Name | KIMBERLY S HOVSEPIAN PA
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 3151 E RIVER RD
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City | NEWKIRK
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State | OK
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Zip | 74647-7517
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Country | US
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Telephone | 580-362-1039
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Fax | 580-362-2988
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Provider Business Mailing Address
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Address Line | 3151 E RIVER RD PO BOX 474
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City | NEWKIRK
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State | OK
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Zip | 74647-7517
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Country | US
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Telephone | 580-362-1039
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Fax | 580-362-2988
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 1500651
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License Number State | KS
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