Provider Demographics
NPI:1679848691
Name:HOVE, LESLIE MARIE (RN)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:MARIE
Last Name:HOVE
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 1:6940 HAMLET AVE
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:WI
Mailing Address - Zip Code:54656-3417
Mailing Address - Country:US
Mailing Address - Phone:608-633-6963
Mailing Address - Fax:
Practice Address - Street 1:6940 HAMLET AVE
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:WI
Practice Address - Zip Code:54656-3417
Practice Address - Country:US
Practice Address - Phone:608-633-6963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI100136-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse