Individual
JEANA UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1511 W CHICKASAW AVE, SALLISAW, OK 74955-7201
(918) 926-7640
(918) 926-7642
Mailing address
1511 W CHICKASAW AVE, SALLISAW, OK 74955-7201
(918) 926-7640
(918) 926-7642
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
118086
OK
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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