Healthcare Provider Details

I. General information

NPI: 1659037810
Provider Name (Legal Business Name): TASHAUNA SHAE OVERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2021
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 N DOBSON RD
SCOTTSDALE AZ
85256-2768
US

IV. Provider business mailing address

7400 N DOBSON RD STE 201
SCOTTSDALE AZ
85256-2770
US

V. Phone/Fax

Practice location:
  • Phone: 602-521-3166
  • Fax:
Mailing address:
  • Phone: 928-660-1676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number270468
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN192202
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: