Provider Demographics
NPI:1386465011
Name:OVERZET, JENNIFER ROSE (HIT, CHW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ROSE
Last Name:OVERZET
Suffix:
Gender:F
Credentials:HIT, CHW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ROSE
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:815 N CLARE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:MI
Mailing Address - Zip Code:48625-8177
Mailing Address - Country:US
Mailing Address - Phone:989-539-6731
Mailing Address - Fax:989-539-4449
Practice Address - Street 1:815 N CLARE AVE STE B
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:MI
Practice Address - Zip Code:48625-8177
Practice Address - Country:US
Practice Address - Phone:989-539-6731
Practice Address - Fax:989-539-4449
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker