Provider Demographics
NPI:1649543422
Name:POLK, URENENA HORTON (RN, BSN)
Entity type:Individual
Prefix:MS
First Name:URENENA
Middle Name:HORTON
Last Name:POLK
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8915 WILLMON WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-1948
Mailing Address - Country:US
Mailing Address - Phone:210-725-9682
Mailing Address - Fax:
Practice Address - Street 1:8915 WILLMON WAY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239-1948
Practice Address - Country:US
Practice Address - Phone:210-725-9682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX521996163W00000X, 174H00000X, 251J00000X, 302R00000X, 305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No174H00000XOther Service ProvidersHealth Educator
No251J00000XAgenciesNursing Care
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305S00000XManaged Care OrganizationsPoint of Service