Provider Demographics
NPI:1811584527
Name:OVERLA, TRISHA ANNE
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:ANNE
Last Name:OVERLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 STILLWATER ST
Mailing Address - Street 2:
Mailing Address - City:WEST MILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45383-1426
Mailing Address - Country:US
Mailing Address - Phone:193-747-7922
Mailing Address - Fax:
Practice Address - Street 1:133 STILLWATER ST
Practice Address - Street 2:
Practice Address - City:WEST MILTON
Practice Address - State:OH
Practice Address - Zip Code:45383-1426
Practice Address - Country:US
Practice Address - Phone:937-477-9225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker