Individual
LYNNE M HOVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1200 S COLUMBIA RD - ALTRU HOSPITAL, GRAND FORKS, ND 58201
(701) 780-6000
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201
(701) 780-1891
(701) 746-7447
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R19638
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026175
BCBS
ND
05
—
12722
—
ND
05
—
154542600
—
MN
01
—
80G63HO
BCBS
MN
01
—
P00387140
RR MEDICARE
—
Enumeration date
08/23/2006
Last updated
03/05/2019
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