Individual
JOAN O BOVARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN FNP-BC
Contact information
Practice address
525 ALEXANDRIA PIKE, SUITE 300, SOUTHGATE, KY 41071
(859) 781-2210
(859) 781-0289
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(849) 212-5478
(859) 212-5037
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3009017
KY
363LF0000X
Family Nurse Practitioner
COA.16659-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100339070
—
KY
Enumeration date
10/13/2014
Last updated
09/13/2018
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