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NPI Code Detail

MEDICARE: JUSTIN AARON UNDERWOOD

MEDICARE: JUSTIN AARON 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
1163W00000XRegistered NurseRN259763GA
2364SA2100XAcute Care Clinical Nurse SpecialistRN259763GA

General Provider Information

NPI Number : 1801724083
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN AARON UNDERWOOD
Provider Business Mailing Address
First Line : 2094 SHADY LN
Second Line :
City : TUCKER
State : GA
Zip : 30084-5509
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 550 PEACHTREE ST NE
Second Line :
City : ATLANTA
State : GA
Zip : 30308-2212
Country : US
Telephone Number : 404-686-4411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2026
Last Update Date : 05/29/2026

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Directions to “ JUSTIN AARON UNDERWOOD ” Practice Location

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