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General NPI Number Information
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NPI Number | 1730840208
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Entity Type | Organization
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Legal Business Name | URBAN UNWIND LLC
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Dates
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Enumeration Date | 01/06/2022
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | 30 7TH ST W
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City | DICKINSON
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State | ND
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Zip | 58601-4335
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Country | US
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Telephone | 701-483-6666
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Fax | 701-483-6667
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Provider Business Mailing Address
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Address Line | PO BOX 406
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City | DICKINSON
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State | ND
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Zip | 58602-0406
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Country | US
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Telephone | 701-483-6666
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Fax | 701-483-6667
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Authorized Official
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Title or Position | CFO/CO-OWNER
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Name | MARLENA STAUDINGER
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Credential |
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Telephone | 701-290-9062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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