Healthcare Provider Details

I. General information

NPI: 1275772980
Provider Name (Legal Business Name): ERIKA LYNN URBAN CPM, LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2009
Last Update Date: 01/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 PARK ROW
SAINT PETER MN
56082-2059
US

IV. Provider business mailing address

526 PARK ROW
SAINT PETER MN
56082-2059
US

V. Phone/Fax

Practice location:
  • Phone: 507-934-4820
  • Fax: 507-934-4828
Mailing address:
  • Phone: 507-934-4820
  • Fax: 507-934-4828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1023
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: