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General NPI Number Information
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NPI Number | 1538804604
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Entity Type | Individual
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Provider Name | CHERYL YVONNE UNDERWOOD RN
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Gender | Female
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Dates
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Enumeration Date | 05/03/2022
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 2600 MARBLE AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-2058
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Country | US
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Telephone | 928-729-8000
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Fax | 505-272-9843
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Provider Business Mailing Address
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Address Line | 166 SANDIA VIEW RD
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City | CORRALES
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State | NM
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Zip | 87048-8716
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Country | US
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Telephone | 727-510-7934
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 78994
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 78994
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 163WW0101X
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Taxonomy Name | Ambulatory Women's Health Care Registered Nurse
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License Number | RN3384592
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License Number State | FL
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