Individual provider · Type 1 NPI
Tracy Bova
Family Nurse Practitioner · Boonville, NY
NPI number
1104058791
Active
Practice location
13407 New York 12
Boonville, NY 13309
Mailing address
511 Tilden Ave
Utica, NY 13501-2007
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 00676527 (NY) |
| Family Nurse Practitioner Primary | 363LF0000X | 338872 (NY) |
Family Nurse Practitioner: Definition to come...
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About NPI 1104058791
Tracy Bova's National Provider Identifier is 1104058791, issued on Aug 14, 2009. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Boonville, NY. The record was last updated on Jul 7, 2014.