| Doctor Name: | JESSICA LYNN UNDERHILL |
| NPI Number: | 1417362880 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DO |
| License Number: | 0 |
| Business Practice Address: | 2345 Dougherty Ferry Rd C/o Medical Education Office Saint Louis, MO - 631223313 |
| Business Phone Number: | 3144191533 |
| Business Fax Number: | |
| Mailing Address: | 2345 Dougherty Ferry Rd, C/o Medical Education Office SAINT LOUIS |
| State: | MO |
| Postal Code: | 631223313 |
| Phone Number: | 3144191533 |
| Fax Number: | |
| NPI Enumeration Date: | 06/24/2014 |
| NPI Last Update Date: | 03/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |