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Individual

ELLEN AMY OVERSON

Active
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Individual

ELLEN AMY OVERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
60094
MN
207R00000X
Internal Medicine Physician
A152846
CA
208000000X
Pediatrics Physician
60094
MN
208000000X
Pediatrics Physician
A152846
CA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/21/2014
Last updated
06/21/2023
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