Provider Demographics
NPI:1821629684
Name:HOVANISYAN, NUNE HASMIK (FNP)
Entity Type:Individual
Prefix:
First Name:NUNE
Middle Name:HASMIK
Last Name:HOVANISYAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:NUNE
Other - Middle Name:
Other - Last Name:HOVHANNISYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2544 E WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-1452
Mailing Address - Country:US
Mailing Address - Phone:626-798-1085
Mailing Address - Fax:626-798-9041
Practice Address - Street 1:2544 E WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-1452
Practice Address - Country:US
Practice Address - Phone:626-798-1085
Practice Address - Fax:626-798-9041
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95013103363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily