Healthcare Provider Details

I. General information

NPI: 1871250043
Provider Name (Legal Business Name): SANDRA DIANE URBINA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2021
Last Update Date: 11/23/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SMITH COUNTY MEMORIAL HOSPITAL 921 EAST HWY 36
P.O BOX 349 KS
66967
US

IV. Provider business mailing address

SMITH COUNTY MEMORIAL HOSPITAL 921 EAST HWY 36
P.O BOX 349 KS
66967
US

V. Phone/Fax

Practice location:
  • Phone: 785-282-6845
  • Fax: 785-282-6331
Mailing address:
  • Phone: 178-528-2684
  • Fax: 785-282-6331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number63535
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: