Provider Demographics
NPI:1619391497
Name:HOVICK, KATIE MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:MARIE
Last Name:HOVICK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 ELM AVE E STE A
Mailing Address - Street 2:
Mailing Address - City:WASECA
Mailing Address - State:MN
Mailing Address - Zip Code:56093-2927
Mailing Address - Country:US
Mailing Address - Phone:507-835-1610
Mailing Address - Fax:507-835-1540
Practice Address - Street 1:122 ELM AVE E STE A
Practice Address - Street 2:
Practice Address - City:WASECA
Practice Address - State:MN
Practice Address - Zip Code:56093-2927
Practice Address - Country:US
Practice Address - Phone:507-835-1610
Practice Address - Fax:507-835-1540
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
MN121359183500000X
IA22058183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist