Provider Demographics
NPI:1770543613
Name:URBAN-PENN, ROSEMARY (ARNP)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:URBAN-PENN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 37TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6550
Mailing Address - Country:US
Mailing Address - Phone:772-569-3100
Mailing Address - Fax:772-569-0217
Practice Address - Street 1:1255 37TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6550
Practice Address - Country:US
Practice Address - Phone:772-569-3100
Practice Address - Fax:772-569-0217
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2992752363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL31195OtherBLUE CROSS
FLP70779Medicare UPIN
FLK0572Medicare PIN