MRS. LEANNE M KOVICK CFM NPI 1962804120

NPI Information

NPI: 1962804120
Provider Name: MRS. LEANNE M KOVICK, CFM
Classification: Mastectomy Fitter - 224900000X
Entity Type: Individual
Address:
2006 BLAINE ST
CALDWELL, ID
ZIP 83605
Phone: (208) 985-5404
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MRS. Leanne M Kovick, CFM is a mastectomy fitter in Caldwell, ID. The provider is an individual trained in the fitting and adjusting of breast prostheses and management of post-mastectomy prostheses services. MRS. Leanne M Kovick, CFM NPI is 1962804120. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2006 BLAINE ST
CALDWELL, ID
ZIP 83605-343
Phone: (208) 985-5404
Fax: (208) 402-5959

The enumeration date for this NPI number is 9/19/2014 and was last updated on 12/7/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	224900000X	Mastectomy Fitter		CFM02746	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7416970001	MEDICARE NSC	IDAHO
2	1962804120	MEDICAID	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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