Provider Demographics
NPI:1093926883
Name:URBAN, PAULA MARIE (CRNP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:MARIE
Last Name:URBAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:804 SERVICE RD STE A109B
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-884-2978
Mailing Address - Fax:517-432-3928
Practice Address - Street 1:1215 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1811
Practice Address - Country:US
Practice Address - Phone:517-364-2670
Practice Address - Fax:517-364-3994
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2021-06-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI47043665002080N0001X
PAUP005028D363LP0200X
MN6894363LW0102X
PASP007610363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health