Provider Demographics
NPI:1891733572
Name:URBANEK, CHARLOTTE LEE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:LEE
Last Name:URBANEK
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:ME
Mailing Address - Zip Code:04917-3809
Mailing Address - Country:US
Mailing Address - Phone:207-446-3024
Mailing Address - Fax:
Practice Address - Street 1:1 VA CTR
Practice Address - Street 2:
Practice Address - City:TOGUS
Practice Address - State:ME
Practice Address - Zip Code:04330-6719
Practice Address - Country:US
Practice Address - Phone:207-623-8411
Practice Address - Fax:207-621-7391
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME024065363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health