Individual
JENNA NICOLE OVERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
44199 DEQUINDRE RD STE 315, TROY, MI 48085-1128
(248) 964-1170
(248) 964-1188
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1861
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301117520
MI
2086S0102X
Surgical Critical Care Physician
Primary
4301117520
MI
Other
Enumeration date
05/13/2013
Last updated
03/29/2021
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