Healthcare Provider Details

I. General information

NPI: 1154723245
Provider Name (Legal Business Name): SANDRA URQUHART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2014
Last Update Date: 09/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 HAMILTON AVENUE
CINCINNATI OH
45231
US

IV. Provider business mailing address

571 CHICORY LN
CINCINNATI OH
45244-1208
US

V. Phone/Fax

Practice location:
  • Phone: 513-728-7637
  • Fax:
Mailing address:
  • Phone: 513-248-1605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN 177457
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: