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Shavonne Larcenia Overton
Family Nurse Practitioner in Bridgeport, Connecticut
NPI 1922713254

Shavonne Larcenia Overton is a Family Nurse Practitioner based in Bridgeport, CT and is specialized in Family. Shavonne Larcenia Overton practices in Bridgeport, CT. The NPI Number for Shavonne Larcenia Overton is 1922713254 and holds a License No. 12.011424 (Connecticut).

The current practice location address for Shavonne Larcenia Overton is 58 Tully Cir, Bridgeport, CT and can be reached out via phone at 860-680-2922.

Location: 58 Tully Cir, Bridgeport, CT, 06610-1116
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1922713254
Provider Name
Shavonne Larcenia Overton
Credential
Provider Entity Type
Individual
Gender
Female
Address
58 Tully Cir, Bridgeport, CT, 06610-1116
Phone Number
860-680-2922
Fax Number
Provider Enumeration Date
01/20/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
58 Tully Cir
City
Bridgeport
State
Connecticut
Zip
06610-1116
Phone Number
860-680-2922
Fax Number
person
Provider Business Mailing Address Details
Address
58 Tully Cir
City
Bridgeport
State
Connecticut
Zip
06610-1116
Phone Number
860-680-2922
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
12.011424 (Connecticut)
Definition
Definition to come...
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