Provider Demographics
NPI:1841289642
Name:URBACH, ANDREA JEANNE (OD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:JEANNE
Last Name:URBACH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-9000
Mailing Address - Fax:
Practice Address - Street 1:1880 N FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-2687
Practice Address - Country:US
Practice Address - Phone:651-438-1800
Practice Address - Fax:651-438-1837
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2834152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0725060001OtherDMERC
MN111314OtherPATIENT CHOICE
MN595809OtherARAZ/TPA/DEFINITY
MN2201698OtherMEDICA CHOICE
MN2201698OtherSELECT CARE
MN961571031014OtherPREFERRED 1 COMM HEALTH
MN230767606OtherVSP
MNN007OtherTRICARE
MN246J1UROtherBCBS OF MN
MN1031014OtherPREFERRED ONE
MN132213OtherUCARE FOR SENIORS
MNHP35473OtherHEALTHPARTNERS
MN2201698OtherMEDICA CHOICE
MN961571031014OtherPREFERRED 1 COMM HEALTH
MN595809OtherARAZ/TPA/DEFINITY