Provider Demographics
NPI:1093739815
Name:KOVAL, NANCY ANNE (APRN NNP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ANNE
Last Name:KOVAL
Suffix:
Gender:F
Credentials:APRN NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 VALLEY BROOK RD
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-6032
Mailing Address - Country:US
Mailing Address - Phone:203-488-3744
Mailing Address - Fax:
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:WP 493
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-688-2320
Practice Address - Fax:203-688-5426
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001746363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal