Provider Demographics
NPI:1811534506
Name:HOVER, AUDRA (APRN, FNP-C, NP-C)
Entity type:Individual
Prefix:
First Name:AUDRA
Middle Name:
Last Name:HOVER
Suffix:
Gender:F
Credentials:APRN, FNP-C, NP-C
Other - Prefix:MRS
Other - First Name:AUDRA
Other - Middle Name:ROSE
Other - Last Name:HOVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5 SPYGLASS HL UNIT 2
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:NJ
Mailing Address - Zip Code:07462-2564
Mailing Address - Country:US
Mailing Address - Phone:973-362-6304
Mailing Address - Fax:
Practice Address - Street 1:33 NEWTON SPARTA RD STE 1
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2764
Practice Address - Country:US
Practice Address - Phone:973-383-2244
Practice Address - Fax:973-383-0448
Is Sole Proprietor?:No
Enumeration Date:2019-12-02
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ257168363LF0000X
NJ26NJ00932400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily