Individual
JOAN STACK KOVACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, BC
Contact information
Practice address
MCLEAN HOSPITAL SOUTHEAST LOCATION, 940 BELMONT STREET, BROCKTON, MA 02301
(508) 894-8316
(508) 894-8334
Mailing address
115 MILL ST, BELMONT, MA 02478-1041
(508) 894-8316
(508) 894-8334
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
111881
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN0237
BCBS
MA
Enumeration date
07/06/2006
Last updated
07/08/2007
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