Individual
MRS. TIAMEKO ROCHELLE OVERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
105 CORPORATE BLVD, LAFAYETTE, LA 70508-3850
(337) 593-9099
(337) 769-8509
Mailing address
PO BOX 51742, LAFAYETTE, LA 70505-1742
(337) 593-9099
(337) 769-8509
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
AP04787
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1630420
—
LA
Enumeration date
10/26/2005
Last updated
12/18/2013
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