Bobby Underwood, CRNFA
Individual provider Active NPI Registered Nurse First Assistant · Mount Pleasant, TN
NPI 1972575512 · NPPES record last updated Feb 20, 2012
Key facts
- NPI
- 1972575512
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse First Assistant 163WR0006X
- License
- RN0000105025 (TN)
- Practice address
- 409 Hay Long Ave
Mount Pleasant, TN 38474-1434 - Phone
- (931) 379-4092
- NPI assigned
- Feb 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN0000105025 | TN | MD | General Practice Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | RN0000105025 | TN | |
| Registered Nurse First Assistant | 163WR0006X | RN0000105025 | TN | Yes |
Addresses
Primary practice location
409 Hay Long Ave
Mount Pleasant, TN 38474-1434
Mailing address
409 Hay Long Ave
Mount Pleasant, TN 38474-1434
Phone (931) 379-4092
Other providers in Mount Pleasant, TN
- Mary Alice Spaulding
- Ryan Richard Sullivan
- Tailwater Practice Partners
- Tadd T Thompson
- Michael L Tyler
- Walgreen Co
- Jykedrin Dantrel Wilson
- Martha Kristin Woodside
- Jennifer Lynn Wright
All providers in Mount Pleasant, TN · Registered Nurse First Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.