Provider Demographics
NPI:1356651020
Name:COOVERT, CHRISTY (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:COOVERT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:
Other - Last Name:MATHERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 2155
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2155
Mailing Address - Country:US
Mailing Address - Phone:606-316-3156
Mailing Address - Fax:
Practice Address - Street 1:300 SAINT CHRISTOPHER DR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7020
Practice Address - Country:US
Practice Address - Phone:606-833-6762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1133885163WX0200X
WV87404163WX0200X
AK6711164W00000X
TN55898164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology
No164W00000XNursing Service ProvidersLicensed Practical Nurse