Individual
JACQUELINE UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
39 ASHWOOD RD, BUTLER, AL 36904-3690
(205) 459-3934
Mailing address
39 ASHWOOD RD, BUTLER, AL 36904-2860
(205) 459-3934
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1-106108
AL
363LA2100X
Acute Care Nurse Practitioner
232595
AZ
363LA2100X
Acute Care Nurse Practitioner
903426
MS
Other
Enumeration date
10/02/2018
Last updated
02/12/2020
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