Provider Demographics
NPI:1750669701
Name:OVERSTREET, KATHRYN SMITH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:SMITH
Last Name:OVERSTREET
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 1:130 SHADOW SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-4820
Mailing Address - Country:US
Mailing Address - Phone:404-395-2360
Mailing Address - Fax:
Practice Address - Street 1:3640 MUNDY MILL RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30504-8218
Practice Address - Country:US
Practice Address - Phone:770-536-4361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA022978183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist