Individual
MS. DEBRA A UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
122 POWELL DR, LEXINGTON, SC 29072-9203
(803) 957-8400
(803) 957-1939
Mailing address
2720 SUNSET BLVD, ATTN CREDENTIALING, WEST COLUMBIA, SC 29169-4810
(803) 936-7681
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4115
SC
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
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