MEDICARE: MRS. LINDA M OVERMAN DPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	6892	TN
2	183500000X	Pharmacist	15856	IA

General Provider Information

NPI Number	:	1356479364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA M OVERMAN DPH

Provider Business Mailing Address
First Line	:	133 SPENCE CREEK LN
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37128-5378
Country	:	US
Telephone Number	:	615-890-9702
Fax Number	:

Provider Business Practice Location Address
First Line	:	608 ENON SPRINGS RD E
Second Line	:
City	:	SMYRNA
State	:	TN
Zip	:	37167-4410
Country	:	US
Telephone Number	:	615-220-5432
Fax Number	:	615-220-5115

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	07/08/2007

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