Provider Demographics
NPI:1881839108
Name:URHAMMER, ANGELA M (APRN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:URHAMMER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 W BROADWAY STE 202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3245
Mailing Address - Country:US
Mailing Address - Phone:502-561-0943
Mailing Address - Fax:502-561-0944
Practice Address - Street 1:645 S ROY WILKINS AVE STE 200
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2072
Practice Address - Country:US
Practice Address - Phone:502-561-0520
Practice Address - Fax:502-561-0521
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2008005001363LG0600X
IN71014384A363LG0600X
KY3009489363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300081852Medicaid
KY7100377910Medicaid