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General NPI Number Information
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NPI Number | 1194143750
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Entity Type | Individual
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Provider Name | CAMILLE URBAN
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Gender | Female
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Dates
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Enumeration Date | 04/01/2014
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-445-9127
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Fax |
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Provider Business Mailing Address
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Address Line | 29714 LINCOLN RD
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City | BAY VILLAGE
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State | OH
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Zip | 44140-1955
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Country | US
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Telephone | 314-422-4814
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN.CNP.15818
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License Number State | OH
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