Healthcare Provider Details

I. General information

NPI: 1972448322
Provider Name (Legal Business Name): PRACTICLEAR PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4566 GOODE RD
GOODE VA
24556-2252
US

IV. Provider business mailing address

4566 GOODE RD
GOODE VA
24556-2252
US

V. Phone/Fax

Practice location:
  • Phone: 704-904-3439
  • Fax:
Mailing address:
  • Phone: 704-904-3439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDREW OVERBEY
Title or Position: OWNER
Credential: NP
Phone: 704-904-3439