Individual
TARA FAITH UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 562-4429
Mailing address
4206 BRIARWOOD RD, LOUISVILLE, KY 40207-4036
(423) 413-6911
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
0024187025
VA
363LA2100X
Acute Care Nurse Practitioner
Primary
4003621
KY
363LG0600X
Gerontology Nurse Practitioner
0024187025
VA
363LG0600X
Gerontology Nurse Practitioner
4003621
KY
Other
Enumeration date
05/22/2023
Last updated
10/19/2023
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