Provider Demographics
NPI:1750628806
Name:HOVANEC, THERESA ANN (CNP)
Entity Type:Individual
Prefix:MISS
First Name:THERESA
Middle Name:ANN
Last Name:HOVANEC
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13637 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2639
Mailing Address - Country:US
Mailing Address - Phone:440-867-8283
Mailing Address - Fax:
Practice Address - Street 1:13637 CEDAR RD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-2639
Practice Address - Country:US
Practice Address - Phone:440-867-8283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.367068163WP0807X, 390200000X
OHCOA.16196-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program