Provider Demographics
NPI:1316970965
Name:OVERSTREET, ARLIENE J (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ARLIENE
Middle Name:J
Last Name:OVERSTREET
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1833 BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32206-4394
Mailing Address - Country:US
Mailing Address - Phone:904-232-2751
Mailing Address - Fax:904-232-3217
Practice Address - Street 1:1833 BOULEVARD
Practice Address - Street 2:METHODIST PROFESSIONAL BUILDING
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32206-4382
Practice Address - Country:US
Practice Address - Phone:904-232-2751
Practice Address - Fax:904-232-3217
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9101984363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant