MEDICARE: BRECKEN ELIZABETH OVERLY PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	7061	TN

General Provider Information

NPI Number	:	1992634679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRECKEN ELIZABETH OVERLY PA

Provider Business Mailing Address
First Line	:	3669 HOGGETT FORD RD
Second Line	:
City	:	HERMITAGE
State	:	TN
Zip	:	37076-3512
Country	:	US
Telephone Number	:	615-773-2712
Fax Number	:	615-773-2707

Provider Business Practice Location Address
First Line	:	40 W CALDWELL ST STE 100
Second Line	:
City	:	MT JULIET
State	:	TN
Zip	:	37122-3180
Country	:	US
Telephone Number	:	615-773-2712
Fax Number	:	615-773-2712

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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Directions to “ BRECKEN ELIZABETH OVERLY PA” Practice Location

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