Provider Demographics
NPI:1235544206
Name:KOVAC, HEATHER (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:KOVAC
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 HART ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-5048
Mailing Address - Country:US
Mailing Address - Phone:203-579-2229
Mailing Address - Fax:203-579-0404
Practice Address - Street 1:89 HART ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-5048
Practice Address - Country:US
Practice Address - Phone:203-579-2229
Practice Address - Fax:203-579-0404
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5690363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health