Provider Demographics
NPI:1245036607
Name:URBACH, JEROLYN
Entity type:Individual
Prefix:
First Name:JEROLYN
Middle Name:
Last Name:URBACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 N 68TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-1615
Mailing Address - Country:US
Mailing Address - Phone:402-643-0287
Mailing Address - Fax:
Practice Address - Street 1:1440 N 68TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-1615
Practice Address - Country:US
Practice Address - Phone:402-643-0287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant