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NPI Code Detail

MEDICARE: DEANA M. UNDERWOOD APRN

MEDICARE: DEANA M. UNDERWOOD APRN
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
1363LF0000XFamily Nurse Practitioner3011418KY

General Provider Information

NPI Number : 1467975649
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEANA M. UNDERWOOD APRN
Provider Business Mailing Address
First Line : PO BOX 936
Second Line :
City : LONDON
State : KY
Zip : 40743-0936
Country : US
Telephone Number : 606-330-7835
Fax Number : 859-263-8807
Provider Business Practice Location Address
First Line : 211 FOUNTAIN CT
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-2694
Country : US
Telephone Number : 859-263-8807
Fax Number : 859-263-8808
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2017
Last Update Date : 03/10/2026

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