Healthcare Provider Details

I. General information

NPI: 1215726880
Provider Name (Legal Business Name): DANIEL J URBAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13919 S PLZ
OMAHA NE
68137-2916
US

IV. Provider business mailing address

1541 S 25TH AVE
OMAHA NE
68105-2612
US

V. Phone/Fax

Practice location:
  • Phone: 402-896-9988
  • Fax:
Mailing address:
  • Phone: 402-806-2829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: