Healthcare Provider Details

I. General information

NPI: 1689964603
Provider Name (Legal Business Name): KATHERINE LUNNEY URBAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHERINE MARIE LUNNEY M.D.

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 CHILDRENS LN CHILDREN'S MEDICAL GROUP - PEDIATRIC SPECIALISTS
NORFOLK VA
23507-1910
US

IV. Provider business mailing address

601 CHILDRENS LN CHILDREN'S MEDICAL GROUP - PEDIATRIC SPECIALISTS
NORFOLK VA
23507-1910
US

V. Phone/Fax

Practice location:
  • Phone: 757-668-7272
  • Fax: 757-668-9766
Mailing address:
  • Phone: 757-668-7272
  • Fax: 757-668-9766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101255648
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: