Provider Demographics
NPI:1568886356
Name:KOVAC, PATRICIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:KOVAC
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 1:8796 ROCKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-2127
Mailing Address - Country:US
Mailing Address - Phone:440-944-3130
Mailing Address - Fax:440-943-9965
Practice Address - Street 1:31500 ROYALVIEW DR
Practice Address - Street 2:
Practice Address - City:WILLOWICK
Practice Address - State:OH
Practice Address - Zip Code:44095-4256
Practice Address - Country:US
Practice Address - Phone:440-944-3130
Practice Address - Fax:440-943-9965
Is Sole Proprietor?:No
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN132025163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool