Healthcare Provider Details

I. General information

NPI: 1689656142
Provider Name (Legal Business Name): PATRICIA B URBANSKI MED, RD, LD,CNSD,CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 09/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 N 8TH AVE E
DULUTH MN
55805-2024
US

IV. Provider business mailing address

330 N 8TH AVE E
DULUTH MN
55805-2024
US

V. Phone/Fax

Practice location:
  • Phone: 218-723-1112
  • Fax: 218-529-9120
Mailing address:
  • Phone: 218-723-1112
  • Fax: 218-529-9120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: