Provider Demographics
NPI:1518587732
Name:URBAIN, SHAWN O'SHAY (RD)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:O'SHAY
Last Name:URBAIN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 JOHN ST STE M-351
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5358
Mailing Address - Country:US
Mailing Address - Phone:269-341-7905
Mailing Address - Fax:
Practice Address - Street 1:601 JOHN ST STE M-351
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5358
Practice Address - Country:US
Practice Address - Phone:269-341-7905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-17
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered