Individual
JESSICA A KOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
850 HARRISON AVE, YACC 4, BOSTON, MA 02118-4001
(617) 414-2080
(617) 414-2090
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
NPP00204-T
RI
363LF0000X
Family Nurse Practitioner
Primary
RN2263982
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043582216
—
MA
Enumeration date
02/03/2012
Last updated
07/17/2014
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