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General NPI Number Information
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NPI Number | 1407711039
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Entity Type | Individual
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Provider Name | SHANNON URBANO
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Gender | Female
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 2400 MORTHLAND DR
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City | VALPARAISO
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State | IN
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Zip | 46383-8329
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Country | US
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Telephone | 219-465-2799
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Fax |
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Provider Business Mailing Address
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Address Line | 10868 N 700 W
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City | DEMOTTE
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State | IN
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Zip | 46310-9720
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26031583A
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License Number State | IN
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