Provider Demographics
NPI:1912663758
Name:OVERSTREET, CARI ANN (APRN)
Entity type:Individual
Prefix:
First Name:CARI
Middle Name:ANN
Last Name:OVERSTREET
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CARI
Other - Middle Name:ANN
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1836 MATT LN
Mailing Address - Street 2:
Mailing Address - City:HENSLEY
Mailing Address - State:AR
Mailing Address - Zip Code:72065-9278
Mailing Address - Country:US
Mailing Address - Phone:501-749-9978
Mailing Address - Fax:
Practice Address - Street 1:3111 S 70TH ST
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5017
Practice Address - Country:US
Practice Address - Phone:479-452-6650
Practice Address - Fax:479-452-5847
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR217960363LP0808X
AR1912663758363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health