Provider Demographics
NPI:1346847829
Name:OVERSTREET, NATASHA M
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:M
Last Name:OVERSTREET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 FULTON RD NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44703-2319
Mailing Address - Country:US
Mailing Address - Phone:216-663-9653
Mailing Address - Fax:
Practice Address - Street 1:702 FULTON RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44703-2319
Practice Address - Country:US
Practice Address - Phone:216-663-9653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant