Provider Demographics
NPI:1699025668
Name:URSAN, EUGENIA (FNP)
Entity Type:Individual
Prefix:
First Name:EUGENIA
Middle Name:
Last Name:URSAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1839 S ALMA SCHOOL RD
Mailing Address - Street 2:SUITE 354
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3023
Mailing Address - Country:US
Mailing Address - Phone:480-726-2287
Mailing Address - Fax:480-821-9360
Practice Address - Street 1:20830 N TATUM BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-7256
Practice Address - Country:US
Practice Address - Phone:480-563-1144
Practice Address - Fax:480-563-2371
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZAP4661207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine