Provider Demographics
NPI:1942075692
Name:OVA, ANNETTE ELLEN (NURSES ASSISTANT)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:ELLEN
Last Name:OVA
Suffix:
Gender:F
Credentials:NURSES ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 5TH ST NW
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-3033
Mailing Address - Country:US
Mailing Address - Phone:701-320-0658
Mailing Address - Fax:
Practice Address - Street 1:814 17TH ST NE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-2737
Practice Address - Country:US
Practice Address - Phone:765-269-6547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator