Provider Demographics
NPI:1326330218
Name:URBINA, SHANNON (RPA)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:URBINA
Suffix:
Gender:F
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 N WILMOT RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-2701
Mailing Address - Country:US
Mailing Address - Phone:520-795-2889
Mailing Address - Fax:520-795-6321
Practice Address - Street 1:677 N WILMOT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2701
Practice Address - Country:US
Practice Address - Phone:520-795-2889
Practice Address - Fax:520-795-6321
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZCRA-20006243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant