Provider Demographics
NPI:1417673237
Name:UNDERHILL, MELISSA A (APRN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:UNDERHILL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CAMPUS CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:NH
Mailing Address - Zip Code:03770-5402
Mailing Address - Country:US
Mailing Address - Phone:603-469-2055
Mailing Address - Fax:
Practice Address - Street 1:7 CAMPUS CENTER DR
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:NH
Practice Address - Zip Code:03770-5402
Practice Address - Country:US
Practice Address - Phone:603-469-2055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH049497-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily