Healthcare Provider Details

I. General information

NPI: 1770543613
Provider Name (Legal Business Name): ROSEMARY URBAN-PENN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 37TH ST SUITE A
VERO BEACH FL
32960-6550
US

IV. Provider business mailing address

1255 37TH ST SUITE A
VERO BEACH FL
32960-6550
US

V. Phone/Fax

Practice location:
  • Phone: 772-569-3100
  • Fax: 772-569-0217
Mailing address:
  • Phone: 772-569-3100
  • Fax: 772-569-0217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP2992752
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: