MEDICARE: MRS. SINEAD URWIN MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133NN1002X	Nutrition Education Nutritionist	LIC201404429	UT

General Provider Information

NPI Number	:	1972993855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SINEAD URWIN MA

Provider Business Mailing Address
First Line	:	2168 S PRESTON ST
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-4111
Country	:	US
Telephone Number	:	646-853-5477
Fax Number	:

Provider Business Practice Location Address
First Line	:	2168 S PRESTON ST
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-4111
Country	:	US
Telephone Number	:	646-853-5477
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2015
Last Update Date	:	01/29/2015

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