| NPI | 1508858598 |
|---|---|
| Former Name | ELLEN N UNDERWOOD-BLUE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71001268A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71001268A) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2022-10-17 |