Provider Demographics
NPI:1376512525
Name:OVERCASH, ANGELA KENT (PA)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:KENT
Last Name:OVERCASH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4309 EMPEROR BLVD STE 125
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-8068
Mailing Address - Country:US
Mailing Address - Phone:919-941-0158
Mailing Address - Fax:919-474-3130
Practice Address - Street 1:4309 EMPEROR BLVD STE 125
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-8068
Practice Address - Country:US
Practice Address - Phone:919-941-0158
Practice Address - Fax:919-474-3130
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103276363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical