Individual
JEROME ELLIS OVERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-4000
Mailing address
187 PLANTERS ROW RD, IRON STATION, NC 28080-6714
(704) 748-3926
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
333863
NC
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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