| NPI | 1467779272 |
|---|---|
| Former Name | REGINA NICOLE UNDERWOOD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN212924) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 358981) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2019-09-17 |