Healthcare Provider Details

I. General information

NPI: 1568903672
Provider Name (Legal Business Name): AMANDA OVERTON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2017
Last Update Date: 03/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 COVEY DR UNIT 100
FRANKLIN TN
37067-6007
US

IV. Provider business mailing address

806 SHADE TREE LN
FRANKLIN TN
37064-0601
US

V. Phone/Fax

Practice location:
  • Phone: 615-472-1550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000022426
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: