Provider Demographics
NPI:1023092046
Name:KOVACS, KLARA M (CNM)
Entity type:Individual
Prefix:
First Name:KLARA
Middle Name:M
Last Name:KOVACS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2866 1ST AVE
Mailing Address - Street 2:SUITE 501
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25702-1200
Mailing Address - Country:US
Mailing Address - Phone:304-697-2035
Mailing Address - Fax:304-523-1485
Practice Address - Street 1:2866 1ST AVE
Practice Address - Street 2:SUITE 501
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-1200
Practice Address - Country:US
Practice Address - Phone:304-697-2035
Practice Address - Fax:304-523-1485
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV102367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0160173000Medicaid
WVNM01622Medicare PIN
WV0160173000Medicaid