Provider Demographics
NPI:1295604544
Name:URBAN, AMY
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:URBAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1053 FARMINGTON AVE # 216
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1574
Mailing Address - Country:US
Mailing Address - Phone:203-464-2573
Mailing Address - Fax:
Practice Address - Street 1:1053 FARMINGTON AVE # 216
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1574
Practice Address - Country:US
Practice Address - Phone:203-464-2573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT81348163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator