Provider Demographics
NPI:1619575420
Name:OVERTON, HALEY (ATC)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:OVERTON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 PATTERSON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1558
Mailing Address - Country:US
Mailing Address - Phone:615-342-6300
Mailing Address - Fax:615-342-6349
Practice Address - Street 1:2400 PATTERSON ST STE 300
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1558
Practice Address - Country:US
Practice Address - Phone:615-342-6300
Practice Address - Fax:615-342-6349
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26792255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer