Individual
LORA OVERACRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
701 GROVE ROAD, GREENVILLE, SC 29605-5611
(864) 455-7000
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6174
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
18655
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
AANA
—
05
—
PENDING
—
SC
Enumeration date
12/13/2013
Last updated
01/08/2019
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