Healthcare Provider Details

I. General information

NPI: 1104220367
Provider Name (Legal Business Name): ANDREW JOSEPH OVERBEY FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 10/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 TATE SPRINGS RD
LYNCHBURG VA
24501-1109
US

IV. Provider business mailing address

2010 ATHERHOLT RD
LYNCHBURG VA
24501-1106
US

V. Phone/Fax

Practice location:
  • Phone: 434-200-7387
  • Fax:
Mailing address:
  • Phone: 434-200-3086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024172132
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: