Provider Demographics
NPI:1689964603
Name:URBAN, KATHERINE LUNNEY (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LUNNEY
Last Name:URBAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MARIE
Other - Last Name:LUNNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:601 CHILDRENS LN
Mailing Address - Street 2:CHILDREN'S MEDICAL GROUP - PEDIATRIC SPECIALISTS
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1910
Mailing Address - Country:US
Mailing Address - Phone:757-668-7272
Mailing Address - Fax:757-668-9766
Practice Address - Street 1:601 CHILDRENS LN
Practice Address - Street 2:CHILDREN'S MEDICAL GROUP - PEDIATRIC SPECIALISTS
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1910
Practice Address - Country:US
Practice Address - Phone:757-668-7272
Practice Address - Fax:757-668-9766
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101255648208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101255648OtherMEDICAL LICENSE
FL4362733OtherDEA