Individual
TAYLOR SUSAN OVERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
615 BERRY RD, NASHVILLE, TN 37204-2855
(615) 904-4002
Mailing address
1703 FLAT ROCK RD, MURFREESBORO, TN 37130-3244
(615) 904-4002
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
66646
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
091815001
DRIVERS LICENSE NUMBER
TN
Enumeration date
01/09/2019
Last updated
01/09/2019
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