Provider Demographics
NPI:1851166565
Name:OVERBY, DAEJAH JANAE
Entity Type:Individual
Prefix:
First Name:DAEJAH
Middle Name:JANAE
Last Name:OVERBY
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 1:4046 STILMORE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44121-2615
Mailing Address - Country:US
Mailing Address - Phone:216-287-8552
Mailing Address - Fax:
Practice Address - Street 1:4046 STILMORE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44121-2615
Practice Address - Country:US
Practice Address - Phone:216-287-8552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide