Provider Demographics
NPI:1386479939
Name:UNDERWOOD, TONYA DENISE
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:DENISE
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 1:828 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3733
Mailing Address - Country:US
Mailing Address - Phone:513-545-0447
Mailing Address - Fax:
Practice Address - Street 1:828 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3733
Practice Address - Country:US
Practice Address - Phone:513-709-4499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care