Provider Demographics
NPI:1356963771
Name:OVERBY, BARBARA JOELLE (DMSC, PA-C)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:JOELLE
Last Name:OVERBY
Suffix:
Gender:F
Credentials:DMSC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1325 W SOUTH JORDAN PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-9060
Mailing Address - Country:US
Mailing Address - Phone:801-232-6556
Mailing Address - Fax:801-987-8467
Practice Address - Street 1:1325 W SOUTH JORDAN PKWY STE 103
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-9060
Practice Address - Country:US
Practice Address - Phone:801-232-6556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-07
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPA907363AM0700X
UT11965136363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical