Provider Demographics
NPI:1467720490
Name:OVERTON, VERONICA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:
Last Name:OVERTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4154 ELVIS PRESLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-5811
Mailing Address - Country:US
Mailing Address - Phone:901-854-5323
Mailing Address - Fax:
Practice Address - Street 1:4154 ELVIS PRESLEY BLVD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-5811
Practice Address - Country:US
Practice Address - Phone:901-398-6233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12998183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist