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Individual

CAROL G UNDERWOOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1484 W 1ST ST N, PRESCOTT, AR 71857-3339
(870) 887-0155
Mailing address
1484 W 1ST ST N, PRESCOTT, AR 71857-3339
(870) 887-0155

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
A01154
AR

Other

Enumeration date
08/24/2015
Last updated
08/24/2015
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