Provider Demographics
NPI:1730573932
Name:SHOVE, NATHAN FRANK (CSFA)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:FRANK
Last Name:SHOVE
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73-4358 WAIPAHE ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-8567
Mailing Address - Country:US
Mailing Address - Phone:808-333-2866
Mailing Address - Fax:
Practice Address - Street 1:73-4358 WAIPAHE ST
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-8567
Practice Address - Country:US
Practice Address - Phone:808-333-2866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant