Provider Demographics
NPI:1124409271
Name:UNDERHILL, CHERYL RAE (RN)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:RAE
Last Name:UNDERHILL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 STRAWBERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02632-3037
Mailing Address - Country:US
Mailing Address - Phone:508-776-8343
Mailing Address - Fax:508-771-7486
Practice Address - Street 1:552 STRAWBERRY HILL RD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02632-3037
Practice Address - Country:US
Practice Address - Phone:508-776-8343
Practice Address - Fax:508-771-7486
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN184352163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse