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NPI Code Detail

MEDICARE: MS. BROOKE NOELLE UNDERWOOD

MEDICARE: MS. BROOKE NOELLE UNDERWOOD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramIN

General Provider Information

NPI Number : 1144159732
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BROOKE NOELLE UNDERWOOD
Provider Business Mailing Address
First Line : 9 N 675 W
Second Line :
City : VALPARAISO
State : IN
Zip : 46385-9226
Country : US
Telephone Number : 219-742-7841
Fax Number :
Provider Business Practice Location Address
First Line : 2005 VALPARAISO ST STE 209
Second Line :
City : VALPARAISO
State : IN
Zip : 46383-3331
Country : US
Telephone Number : 219-252-5464
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2026
Last Update Date : 05/18/2026

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Directions to “ MS. BROOKE NOELLE UNDERWOOD ” Practice Location

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