Teresa Underwood (NPI# 1912476458, PAC ID# 1658619259) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1912476458 |
| PAC ID by PECOS | 1658619259 |
| Professional Enrollment ID | I20190605003062 |
| Full Name | Teresa Underwood |
| Organization Legal Name | LIFETREE MEDICAL SERVICES LLC |
| Address |
150 Venus Dr Gary WV 24836 |
| Phone Number | 3044482121 |
| Gender | F |
| Graduation Year | 2018 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 8426314667 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 150 Venus Dr, Gary, WV 24836 | 3044482121 | LIFETREE MEDICAL SERVICES LLC |
| 236 Warrior Way, New Richmond, WV 24867 | 3042947586 | LIFETREE MEDICAL SERVICES LLC |
| Organization Legal Name | LIFETREE MEDICAL SERVICES LLC |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rebecca Lynn Derossett | Nurse Practitioner | Lifetree Medical Services LLC | 30 Hidden Brook Way, Culloden, WV 25510-9190 |
| Susan Rae Rash | Nurse Practitioner | Lifetree Medical Services LLC | 1115 Maplewood Ave, Lewisburg, WV 24901-9728 |
| Whitney A Crook | Nurse Practitioner | Lifetree Medical Services LLC | 1275 Southview Dr, Bluefield, WV 24701-4347 |
| Dodi L Bowen | Nurse Practitioner | Lifetree Medical Services LLC | 859 Days Dr, Sutton, WV 26601-6255 |
| Karie Rabagia | Nurse Practitioner | Lifetree Medical Services LLC | 1081 Maplewood Dr, Bridgeport, WV 26330-9848 |
| Julie Carol Furrow | Nurse Practitioner | Lifetree Medical Services LLC | Rr 4 Box, Suite 20, Cameron, WV 26033-9520 |
| Sherri D Arthur | Nurse Practitioner | Lifetree Medical Services LLC | 100 Hresan Blvd, Fayetteville, WV 25840-1333 |
| Street Address |
150 VENUS DR |
| City | GARY |
| State | WV |
| Zip | 24836 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brandon Michael Lingenfelter | Obstetrics/gynecology | Rt 103 Supply St, Gary, WV 24836 | |
| Brenda C Beach | Nurse Practitioner | Tug River Health Association, Inc. | Route 103 Wall St, Gary, WV 24836 |
| City | GARY |
| Zip Code | 24836 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | GARY + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.