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General NPI Number Information
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NPI Number | 1396580452
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Entity Type | Individual
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Provider Name | ROYLYNN UNDERWOOD PMHNP
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Gender | Female
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Dates
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Enumeration Date | 06/28/2024
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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 | 458-488-1000
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Fax | 458-488-1001
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Provider Business Mailing Address
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Address Line | 7737 OLD STAGE RD
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City | CENTRAL POINT
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State | OR
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Zip | 97502-9717
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Country | US
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Telephone | 503-819-1064
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 10032035
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 200440705RN
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License Number State | OR
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