Individual
LILIA ANN UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
800 GRAND CENTRAL MALL, SUITE 4, VIENNA, WV 26105-4100
(304) 485-4439
(304) 485-6489
Mailing address
800 GRAND CENTRAL MALL, SUITE 4, VIENNA, WV 26105-4100
(304) 485-4439
(304) 485-6489
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
41261
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2198152
—
OH
05
—
7105020000
—
WV
Enumeration date
05/27/2005
Last updated
05/03/2011
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