Healthcare Provider Details

I. General information

NPI: 1881501971
Provider Name (Legal Business Name): OVERSTREET MEDICAL CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 PASADENA DR STE 50
LEXINGTON KY
40503-3087
US

IV. Provider business mailing address

3717 COTTAGE CIR
LEXINGTON KY
40513-1114
US

V. Phone/Fax

Practice location:
  • Phone: 859-233-8494
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KAYE OVERSTREET
Title or Position: OWNER/NURSE PRACTICE
Credential: APRN
Phone: 859-233-8494