Provider Demographics
NPI:1578029948
Name:UNDERWOOD, DEBBIE LYNN
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:LYNN
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 PUTNAM LN
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75021-8845
Mailing Address - Country:US
Mailing Address - Phone:903-624-6998
Mailing Address - Fax:
Practice Address - Street 1:68 PUTNAM LN
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75021-8845
Practice Address - Country:US
Practice Address - Phone:903-624-6998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX888128163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse