Provider Demographics
NPI:1336440163
Name:OVERSTREET, BRENDA RUTH (ARNP)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:RUTH
Last Name:OVERSTREET
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3205 SUMMIT SQUARE PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2650
Mailing Address - Country:US
Mailing Address - Phone:859-335-9041
Mailing Address - Fax:859-335-9072
Practice Address - Street 1:3205 SUMMIT SQUARE PL
Practice Address - Street 2:SUITE 100
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2650
Practice Address - Country:US
Practice Address - Phone:859-335-9041
Practice Address - Fax:859-335-9072
Is Sole Proprietor?:No
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY6621P363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care