Provider Demographics
NPI:1275710717
Name:HANKEY UNDERWOOD, DIANA MARIE (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:MARIE
Last Name:HANKEY UNDERWOOD
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:MARIE
Other - Last Name:HANKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP-BC
Mailing Address - Street 1:2508 RILEYS PASS SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35803-2975
Mailing Address - Country:US
Mailing Address - Phone:256-270-9493
Mailing Address - Fax:
Practice Address - Street 1:3007 MEMORIAL PKWY SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5393
Practice Address - Country:US
Practice Address - Phone:256-799-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1115553363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510G700038OtherMEDICARE GROUP NUMBER