Individual
MELISSA A OVERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
520 S 7TH ST, VINCENNES, IN 47591-1038
(812) 882-3243
(812) 885-3915
Mailing address
2200 STATE ST, LAWRENCEVILLE, IL 62439-1852
(618) 943-1000
(618) 943-7230
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085003223
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001056820
ANTHEM
IN
01
—
258190082
MEDICARE
IN
05
—
300008247
—
IN
Enumeration date
09/20/2006
Last updated
12/15/2017
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