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General NPI Number Information
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NPI Number | 1114752086
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Entity Type | Organization
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Legal Business Name | ROYLYNN UNDERWOOD, PMHNP, LLC
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Dates
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Enumeration Date | 09/03/2024
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Last Update Date | 11/23/2025
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Provider Practice Location Address
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Address Line | 824 E JACKSON ST STE A
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City | MEDFORD
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State | OR
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Zip | 97504-6745
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Country | US
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Telephone | 458-488-1001
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Fax | 458-488-1001
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Provider Business Mailing Address
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Address Line | 824 E JACKSON ST STE A
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City | MEDFORD
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State | OR
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Zip | 97504-6745
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Country | US
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Telephone | 458-488-1000
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Fax | 458-488-1001
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | ROYLYNN DOLORES UNDERWOOD
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Credential | APRN
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Telephone | 458-488-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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