Individual
SHAVONNE LARCENIA OVERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
158 AMITY RD # 280, NEW HAVEN, CT 06515-1405
(203) 404-3463
(203) 563-9255
Mailing address
PO BOX 745254, ATLANTA, GA 30374-5254
(773) 352-1515
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
12.011424
CT
Other
Enumeration date
01/20/2023
Last updated
04/17/2025
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