Provider Demographics
NPI:1265624936
Name:CHOVAN, JOHN D (PHD RN CNP CNS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:CHOVAN
Suffix:
Gender:M
Credentials:PHD RN CNP CNS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5350 FRANTZ RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4259
Mailing Address - Country:US
Mailing Address - Phone:614-544-6366
Mailing Address - Fax:614-544-6350
Practice Address - Street 1:111 S GRANT AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4701
Practice Address - Country:US
Practice Address - Phone:614-566-8210
Practice Address - Fax:614-566-8074
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.324050-COA2163W00000X
OHCOA.09532-NP363LP0808X
OHCOA.09583-NS364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH11811999OtherCAQH UNIVERSAL CREDENTIALING DATASOURCE PROVIDER ID
OHCHNP24211OtherMEDICARE PTAN