Healthcare Provider Details

I. General information

NPI: 1407319668
Provider Name (Legal Business Name): KAREN L URBAN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2019
Last Update Date: 04/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 HEALTHY WAY STE 300
VIRGINIA BEACH VA
23462-7958
US

IV. Provider business mailing address

2241 CREEKS EDGE DR
VIRGINIA BEACH VA
23451-6843
US

V. Phone/Fax

Practice location:
  • Phone: 757-481-4817
  • Fax: 757-481-7138
Mailing address:
  • Phone: 970-216-6836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024177357
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: