Provider Demographics
NPI:1063994663
Name:HOVATTER, KRISTIN RUSHELLE (AUD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:RUSHELLE
Last Name:HOVATTER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:RUSHELLEE
Other - Last Name:HOVATTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD
Mailing Address - Street 1:6700 WASHINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3405
Mailing Address - Country:US
Mailing Address - Phone:612-351-1529
Mailing Address - Fax:
Practice Address - Street 1:102 MATTHEW DR UNIT 102
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8418
Practice Address - Country:US
Practice Address - Phone:724-439-0210
Practice Address - Fax:724-439-0281
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006610231H00000X
WVA-0347231H00000X
PA237700000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist