Provider Demographics
NPI:1023561305
Name:SCOVENS, ERNESTINE
Entity Type:Individual
Prefix:
First Name:ERNESTINE
Middle Name:
Last Name:SCOVENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 SOLAR CIR
Mailing Address - Street 2:APT E
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-6832
Mailing Address - Country:US
Mailing Address - Phone:443-325-2468
Mailing Address - Fax:
Practice Address - Street 1:48 SOLAR CIR
Practice Address - Street 2:APT E
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-6832
Practice Address - Country:US
Practice Address - Phone:443-325-2468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR210972163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse