Provider Demographics
NPI:1346802766
Name:HOVERMALE, STEVEN (FNP)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:HOVERMALE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:STEVEN
Other - Middle Name:
Other - Last Name:HOVERMALE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:1056 TWIN OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-7000
Mailing Address - Country:US
Mailing Address - Phone:606-336-1380
Mailing Address - Fax:
Practice Address - Street 1:125 FOXGLOVE DR STE D
Practice Address - Street 2:
Practice Address - City:MOUNT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-9735
Practice Address - Country:US
Practice Address - Phone:859-498-3333
Practice Address - Fax:859-498-3332
Is Sole Proprietor?:No
Enumeration Date:2019-07-05
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1134462163W00000X
KY3013599363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3013599OtherKY APRN LICENSE