Individual
ALLISON KELLY UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,BA,RN
Contact information
Practice address
400 COLUMBUS AVE, NEW HAVEN, CT 06519-1233
(203) 503-3000
Mailing address
400 COLUMBUS AVE, NEW HAVEN, CT 06519-1233
(203) 503-3000
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6174
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008060919
—
CT
Enumeration date
09/30/2013
Last updated
12/14/2020
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