Doctor Name: | CARLA N OVERSTREET |
NPI Number: | 1154795508 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | 201508759NP-PP |
Business Practice Address: | 870 S Front St Ste 200 Central Point, OR - 975022779 |
Business Phone Number: | 5416643346 |
Business Fax Number: | |
Mailing Address: | Po Box 3158, PORTLAND |
State: | OR |
Postal Code: | 972083158 |
Phone Number: | 5416643346 |
Fax Number: | |
NPI Enumeration Date: | 11/23/2015 |
NPI Last Update Date: | 11/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 201508759NP-PP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |