Provider Demographics
NPI:1821378894
Name:OVERSTREET, ELIZABETH JULYN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:JULYN
Last Name:OVERSTREET
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-7108
Mailing Address - Country:US
Mailing Address - Phone:662-453-2627
Mailing Address - Fax:
Practice Address - Street 1:1003 SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-7108
Practice Address - Country:US
Practice Address - Phone:662-453-2627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR867695363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily