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General NPI Number Information
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NPI Number | 1942775754
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Entity Type | Individual
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Provider Name | KEEGAN TUCKER OVERBEY ARNP
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Gender | Male
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 12/05/2018
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Provider Practice Location Address
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Address Line | 200 HAWKINS DR
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City | IOWA CITY
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State | IA
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Zip | 52242-1009
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Country | US
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Telephone | 319-356-1616
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Fax |
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Provider Business Mailing Address
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Address Line | 2275 BISON ST UNIT J
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City | MARION
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State | IA
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Zip | 52302-4895
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Country | US
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Telephone | 209-312-4770
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Fax |
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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 | A141699
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License Number State | IA
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