Provider Demographics
NPI:1407132277
Name:BOVA-HICKEY, BERNADETTE ANGELINA (RN)
Entity Type:Individual
Prefix:MISS
First Name:BERNADETTE
Middle Name:ANGELINA
Last Name:BOVA-HICKEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2732 N AVENIDA VALIENTE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-2830
Mailing Address - Country:US
Mailing Address - Phone:520-307-2003
Mailing Address - Fax:
Practice Address - Street 1:2732 N AVENIDA VALIENTE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-2830
Practice Address - Country:US
Practice Address - Phone:520-307-2003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN168196163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZRN168196OtherRN