Provider Demographics
NPI:1669882619
Name:POLSKA, URSZULA ANNA (MSN, CRNP)
Entity type:Individual
Prefix:MRS
First Name:URSZULA
Middle Name:ANNA
Last Name:POLSKA
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:MRS
Other - First Name:URSZULA
Other - Middle Name:ANNA
Other - Last Name:PAWLOWSKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN, CRNP
Mailing Address - Street 1:28720 US HIGHWAY 98 STE 1
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-7268
Mailing Address - Country:US
Mailing Address - Phone:251-263-3229
Mailing Address - Fax:936-244-4455
Practice Address - Street 1:28720 US HIGHWAY 98 STE 1
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-7268
Practice Address - Country:US
Practice Address - Phone:251-263-3229
Practice Address - Fax:936-244-4455
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-093688363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner