Individual
KIMBERLY LYNN UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1934 NILES CORTLAND RD NE STE B, WARREN, OH 44484-1055
(330) 841-4032
(330) 841-4381
Mailing address
1934 NILES CORTLAND RD NE STE B, WARREN, OH 44484-1055
(330) 841-4032
(330) 841-4381
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.002206
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0084823
—
OH
Enumeration date
03/15/2007
Last updated
06/08/2020
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