| Doctor Name: | CHRISTA JAYLEEN KOVACHEVICH |
| NPI Number: | 1649642034 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP, CPNP-PC |
| License Number: | 9390419 |
| Business Practice Address: | 1381 S Patrick Dr Patrick Afb, FL - 329253606 |
| Business Phone Number: | 3214948241 |
| Business Fax Number: | |
| Mailing Address: | 1381 S Patrick Dr, PATRICK AFB |
| State: | FL |
| Postal Code: | 329253606 |
| Phone Number: | 3214948241 |
| Fax Number: | |
| NPI Enumeration Date: | 10/23/2015 |
| NPI Last Update Date: | 12/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 9390419 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |