Healthcare Provider Details

I. General information

NPI: 1285698894
Provider Name (Legal Business Name): VICTORIA OVERCOMER APRN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4695 MACARTHUR CT # 1112A
NEWPORT BEACH CA
92660-1882
US

IV. Provider business mailing address

4695 MACARTHUR CT # 1112A
NEWPORT BEACH CA
92660-1882
US

V. Phone/Fax

Practice location:
  • Phone: 614-377-0268
  • Fax:
Mailing address:
  • Phone: 614-377-0268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95027738
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number117522
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN 368023
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06162475
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: