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General NPI Number Information
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NPI Number | 1215291067
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Entity Type | Individual
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Provider Name | GRETCHEN ANNE OVERSTOLZ FNP
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Gender | Female
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Dates
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Enumeration Date | 06/26/2012
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Last Update Date | 02/16/2025
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Provider Practice Location Address
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Address Line | 4400 DORCHESTER RD
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City | NORTH CHARLESTON
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State | SC
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Zip | 29405-6849
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Country | US
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Telephone | 843-278-8291
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Fax |
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Provider Business Mailing Address
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Address Line | 4400 DORCHESTER RD STE 117
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City | NORTH CHARLESTON
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State | SC
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Zip | 29405-6930
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Country | US
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Telephone | 843-804-8286
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Fax | 843-279-3119
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3749
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License Number State | SC
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