Healthcare Provider Details

I. General information

NPI: 1487573978
Provider Name (Legal Business Name): JULIA OVERTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIA ANDERSON

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2629 VINEYARD WAY
MEMPHIS IN
47143-1408
US

IV. Provider business mailing address

2629 VINEYARD WAY
MEMPHIS IN
47143-1408
US

V. Phone/Fax

Practice location:
  • Phone: 502-821-9504
  • Fax:
Mailing address:
  • Phone: 502-821-9504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28263077C
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: