Provider Demographics
NPI:1750716692
Name:OVERSTREET, REBEKAH HOUSTON (FNP)
Entity type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:HOUSTON
Last Name:OVERSTREET
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:EUPORA
Mailing Address - State:MS
Mailing Address - Zip Code:39744-2064
Mailing Address - Country:US
Mailing Address - Phone:662-258-7200
Mailing Address - Fax:662-258-9230
Practice Address - Street 1:1301 VETERANS MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:EUPORA
Practice Address - State:MS
Practice Address - Zip Code:39744-2064
Practice Address - Country:US
Practice Address - Phone:662-258-7200
Practice Address - Fax:662-258-9230
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR885859363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily