MEDICARE: ANGELA BOVA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	APRN.CNP.0032869	OH

General Provider Information

NPI Number	:	1053024836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA BOVA

Provider Business Mailing Address
First Line	:	3949 LEGENDARY RIDGE LN
Second Line	:
City	:	CLEVES
State	:	OH
Zip	:	45002-2395
Country	:	US
Telephone Number	:	513-467-0243
Fax Number	:

Provider Business Practice Location Address
First Line	:	7763 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-4201
Country	:	US
Telephone Number	:	513-891-5438
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2022
Last Update Date	:	06/05/2023

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Directions to “ ANGELA BOVA ” Practice Location

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