Provider Demographics
NPI:1396469276
Name:UNDERWOOD, TIFFANY A (CERTIFIED DOULA)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:A
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:CERTIFIED DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2729 WILLOW REST DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38133-5000
Mailing Address - Country:US
Mailing Address - Phone:901-553-6936
Mailing Address - Fax:
Practice Address - Street 1:2729 WILLOW REST DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38133-5000
Practice Address - Country:US
Practice Address - Phone:901-553-6936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty