Individual
BRIAN OVERSTREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 984-5571
(601) 984-5583
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 984-5571
(601) 984-5583
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP136188
TX
363LA2100X
Acute Care Nurse Practitioner
R878670
MS
363LP2300X
Primary Care Nurse Practitioner
Primary
R878670
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05873296
—
MS
05
—
2408143
—
LA
Enumeration date
06/11/2014
Last updated
12/04/2023
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