| NPI | 1558083659 |
|---|---|
| Former Name | JACOB OVERDURFF |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 088938-23) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NH 088938-21) |
| Enumeration Date | 2022-09-15 |
| Last Update Date | 2026-02-13 |