Provider Demographics
NPI:1972648111
Name:OVERKO, LINDSAY L (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:L
Last Name:OVERKO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:LEIGH
Other - Last Name:LABORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:248 PLEASANT ST STE 2800
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7529
Mailing Address - Country:US
Mailing Address - Phone:603-415-6464
Mailing Address - Fax:603-227-7576
Practice Address - Street 1:248 PLEASANT ST STE 2800
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7529
Practice Address - Country:US
Practice Address - Phone:603-415-6464
Practice Address - Fax:603-227-7576
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03252255A2300X
NH0839363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3075343Medicaid