Provider Demographics
NPI:1093304008
Name:URBANO, MARJORIE A (RN)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:A
Last Name:URBANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 SURREYGLEN WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-5611
Mailing Address - Country:US
Mailing Address - Phone:916-919-6855
Mailing Address - Fax:866-308-4092
Practice Address - Street 1:5101 SURREYGLEN WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-5611
Practice Address - Country:US
Practice Address - Phone:916-919-6855
Practice Address - Fax:866-308-4092
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA529464163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse