Healthcare Provider Details
I. General information
NPI: 1902818966
Provider Name (Legal Business Name): DONNA URBINATI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/11/2006
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
160 WOLCOTT ST
BRISTOL CT
06010-6422
US
IV. Provider business mailing address
4 FARM SPRINGS RD PROHEALTH PHYSICIANS
FARMINGTON CT
06032-2573
US
V. Phone/Fax
- Phone: 860-589-8872
- Fax: 860-589-6468
- Phone: 860-284-5200
- Fax: 860-284-5333
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | 001218 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: