Provider Demographics
NPI:1336144609
Name:COVERSTONE, JOHN AARON (AUD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:AARON
Last Name:COVERSTONE
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 OLD HIGHWAY 8 NW STE 200
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-2777
Mailing Address - Country:US
Mailing Address - Phone:651-628-4327
Mailing Address - Fax:651-282-0278
Practice Address - Street 1:929 OLD HIGHWAY 8 NW STE 200
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-2777
Practice Address - Country:US
Practice Address - Phone:651-628-4327
Practice Address - Fax:651-282-0278
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7496231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN683565100Medicaid
MN640000258Medicare ID - Type Unspecified