Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 14643 | TN |
NPI | 1003146630 |
---|---|
Provider Name | Barbara A Overbey |
First Address | Memphis, TN 38120-9411 |
Second Address | Memphis, TN 38120-9411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2010 |
Last Update Date | 05/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03108811 | (05) | MS |
1003146630 | (05) | MO |
210618758 | (05) | AR |
P01096559 | RR MEDICARE (01) | TN |
Q000173 | (05) | TN |