Doctor Name: | MRS. BAILEY HARDY UNDERHILL |
NPI Number: | 1003171265 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 0010-03683 |
Business Practice Address: | 3000 New Bern Ave Raleigh, NC - 276101231 |
Business Phone Number: | 9193508000 |
Business Fax Number: | |
Mailing Address: | 517 N 1st Ave, KNIGHTDALE |
State: | NC |
Postal Code: | 275458505 |
Phone Number: | 9102801294 |
Fax Number: | |
NPI Enumeration Date: | 07/12/2012 |
NPI Last Update Date: | 08/14/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 0010-03683 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |