Provider Demographics
NPI:1780672386
Name:URIEL, LUANNE (CNM/ARNP)
Entity Type:Individual
Prefix:MRS
First Name:LUANNE
Middle Name:
Last Name:URIEL
Suffix:
Gender:F
Credentials:CNM/ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E FAIRMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-7444
Mailing Address - Country:US
Mailing Address - Phone:727-433-1016
Mailing Address - Fax:605-610-4072
Practice Address - Street 1:211 E FAIRMONT BLVD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-7444
Practice Address - Country:US
Practice Address - Phone:727-433-1016
Practice Address - Fax:605-610-4072
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704328990367A00000X
FLARNP9180640367A00000X
WY1416367A00000X
SDCM000054367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDCM000054OtherCNM LICENSE
WY1416OtherCNM LICENSE
SD6540632Medicaid