Basic Information
| Provider Information | |||||||||
| NPI: | 1285698894 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OVERCOMER | ||||||||
| FirstName: | VICTORIA | ||||||||
| MiddleName: | |||||||||
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| Credential: | APRN FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5298 PRATER DR | ||||||||
| Address2: | |||||||||
| City: | GROVEPORT | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431259137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145928269 | ||||||||
| FaxNumber: | 6142231732 | ||||||||
| Practice Location | |||||||||
| Address1: | 5797 BEECHCROFT RD STE F | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432292758 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145002500 | ||||||||
| FaxNumber: | 6143693723 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2006 | ||||||||
| LastUpdateDate: | 01/23/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 117522 | OH | N | Nursing Service Providers | Licensed Practical Nurse | 363LF0000X | F06162475 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 163W00000X | RN 368023 | OH | N | Nursing Service Providers | Registered Nurse |
No ID Information.