Healthcare Provider Details

I. General information

NPI: 1245653732
Provider Name (Legal Business Name): HEATHER OVERBECK CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2014
Last Update Date: 08/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 AUBURN AVE SU. 137
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

237 WILLIAM HOWARD TAFT RD 2ND FLOOR, CBO2-3
CINCINNATI OH
45219-2610
US

V. Phone/Fax

Practice location:
  • Phone: 513-206-1180
  • Fax: 513-206-1183
Mailing address:
  • Phone: 513-206-1180
  • Fax: 513-206-1183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number15405
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: