Individual
MRS. ANDREA EWING OVERSTREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
10511 DIBERVILLE BLVD, DIBERVILLE, MS 39540-2403
(228) 392-3905
(228) 392-3905
Mailing address
2015 BENT OAKS BLVD, BILOXI, MS 39531-2414
(228) 392-3905
(228) 392-3905
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
12687
AL
183500000X
Pharmacist
Primary
T09130
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0330474
—
MS
Enumeration date
09/22/2006
Last updated
07/08/2007
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