Provider Demographics
NPI:1992421762
Name:OVERTON, KIMBERLY A (RN)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:OVERTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 CREEKSIDE CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3063
Mailing Address - Country:US
Mailing Address - Phone:615-495-0707
Mailing Address - Fax:
Practice Address - Street 1:106 CREEKSIDE CT
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3063
Practice Address - Country:US
Practice Address - Phone:615-495-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN225471374T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel