Healthcare Provider Details

I. General information

NPI: 1508774217
Provider Name (Legal Business Name): HALEY OVERTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 PENNINGTON CHAPEL RD NW
RAMSEY IN
47166-8221
US

IV. Provider business mailing address

1645 PENNINGTON CHAPEL RD NW
RAMSEY IN
47166-8221
US

V. Phone/Fax

Practice location:
  • Phone: 252-642-4283
  • Fax:
Mailing address:
  • Phone: 252-642-4283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number45024671A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: