Provider Demographics
NPI:1689354664
Name:OVERGAARD, KATE MARIE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:MARIE
Last Name:OVERGAARD
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:603 BRUCE ST
Mailing Address - Street 2:
Mailing Address - City:CROOKSTON
Mailing Address - State:MN
Mailing Address - Zip Code:56716-2914
Mailing Address - Country:US
Mailing Address - Phone:218-281-3940
Mailing Address - Fax:218-955-7150
Practice Address - Street 1:1422 CENTRAL AVE NW
Practice Address - Street 2:
Practice Address - City:EAST GRAND FORKS
Practice Address - State:MN
Practice Address - Zip Code:56721
Practice Address - Country:US
Practice Address - Phone:218-773-6102
Practice Address - Fax:218-955-7150
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN10464363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health