| NPI | 1780128439 |
|---|---|
| Former Name | JOHANNA OVERSTREET |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 107770) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-144007) |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2024-02-20 |