Healthcare Provider Details

I. General information

NPI: 1003276627
Provider Name (Legal Business Name): AMY URBAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2016
Last Update Date: 12/07/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE S LOWDER BLDG., SUITE 618
BIRMINGHAM AL
35233-1711
US

IV. Provider business mailing address

1600 7TH AVE S MCWANE BLDG., SUITE 5604
BIRMINGHAM AL
35233-1711
US

V. Phone/Fax

Practice location:
  • Phone: 205-638-9918
  • Fax:
Mailing address:
  • Phone: 205-638-9918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1-085430
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: