Individual
MARISSA F KLEFFMAN UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1204 E FIRE TOWER RD, GREENVILLE, NC 27858-4196
(252) 744-1122
(252) 744-1133
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP9467370
FL
363LF0000X
Family Nurse Practitioner
Primary
264412
NC
363LF0000X
Family Nurse Practitioner
5008128
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144691528
—
NC
01
—
19GSY
BCBS OF NC
—
01
—
NCR001B
MEDICARE
NC
Enumeration date
10/12/2015
Last updated
02/16/2024
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