Healthcare Provider Details

I. General information

NPI: 1487463949
Provider Name (Legal Business Name): MARIA GUADALUPE URBINA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA GUADALUPE GURROLA

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 W DERBY ST PO BOX 637
OXFORD NE
68967-0637
US

IV. Provider business mailing address

502 W DERBY ST PO BOX 637
OXFORD NE
68967-0637
US

V. Phone/Fax

Practice location:
  • Phone: 308-824-3283
  • Fax: 308-824-3356
Mailing address:
  • Phone: 308-824-3283
  • Fax: 308-824-3356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: