Provider Demographics
NPI:1174392658
Name:OVERCASH, SUNNILEE (APRN)
Entity type:Individual
Prefix:
First Name:SUNNILEE
Middle Name:
Last Name:OVERCASH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SUNNI
Other - Middle Name:
Other - Last Name:MCDERMAID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:746 E WINCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-8512
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:746 E WINCHESTER ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-8512
Practice Address - Country:US
Practice Address - Phone:801-654-0443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8635969-8900363LF0000X
UT8635969-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily