Provider Demographics
NPI:1689047698
Name:URBAN, DOROTA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:DOROTA
Middle Name:
Last Name:URBAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DOROTA
Other - Middle Name:
Other - Last Name:URBAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC, PMHNP-BC
Mailing Address - Street 1:609 W JOHNSON AVE UNIT 304
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-4505
Mailing Address - Country:US
Mailing Address - Phone:860-348-3668
Mailing Address - Fax:
Practice Address - Street 1:609 W JOHNSON AVE UNIT 304
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-4505
Practice Address - Country:US
Practice Address - Phone:860-348-3668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-12
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12.006382363LF0000X
CT6382363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily