Provider Demographics
NPI:1356397061
Name:BOVE, CATHERINE N (NP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:N
Last Name:BOVE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 SALEM WOODSTOWN RD STE 8
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NJ
Mailing Address - Zip Code:08079-2034
Mailing Address - Country:US
Mailing Address - Phone:856-469-8825
Mailing Address - Fax:
Practice Address - Street 1:330 SALEM WOODSTOWN RD STE 8
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NJ
Practice Address - Zip Code:08079-2034
Practice Address - Country:US
Practice Address - Phone:856-469-8825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN06700100363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8809500Medicaid
NJ8809500Medicaid
S47977Medicare UPIN