Provider Demographics
NPI:1346305737
Name:HOVEN, MELISSA K (OD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:K
Last Name:HOVEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120-12TH AVE E
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308
Mailing Address - Country:US
Mailing Address - Phone:320-763-4321
Mailing Address - Fax:320-763-6921
Practice Address - Street 1:120 12TH AVE E
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308
Practice Address - Country:US
Practice Address - Phone:320-763-4321
Practice Address - Fax:320-763-6921
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2703152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP26440OtherHEALTH PARTNERS
MN030701053OtherPRIMEWEST
MN1017434OtherPREFERRED ONE
MN150778OtherUCARE
MN22007665OtherMEDICA
MN23375OtherAVESIS
MN89D88HOOtherBCBS
MN959716600Medicaid
MNP00279901OtherRAILRAOD MEDICARE
MN150778OtherUCARE
MN959716600Medicaid