Individual
SHAWNA RAE UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2727 W BELL RD, PHOENIX, AZ 85053-3059
(602) 680-2386
Mailing address
2727 W BELL RD, PHOENIX, AZ 85053-3059
(602) 680-2386
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
AP3843
AZ
363L00000X
Nurse Practitioner
Primary
AP3843
AZ
Other
Enumeration date
12/02/2010
Last updated
03/03/2015
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