Provider Demographics
NPI:1912588666
Name:SOVA, JEANNE (RN)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:SOVA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 CHANCERY LN
Mailing Address - Street 2:
Mailing Address - City:CAVE SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72718-9104
Mailing Address - Country:US
Mailing Address - Phone:651-271-2694
Mailing Address - Fax:
Practice Address - Street 1:1007 CHANCERY LN
Practice Address - Street 2:
Practice Address - City:CAVE SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72718-9104
Practice Address - Country:US
Practice Address - Phone:651-271-2694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR106590163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse