1871250043 NPI number — MRS. SANDRA DIANE URBINA RN

Table of content: (NPI 1588039291)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871250043 NPI number — MRS. SANDRA DIANE URBINA RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
URBINA
Provider First Name:
SANDRA
Provider Middle Name:
DIANE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871250043
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/23/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
SMITH COUNTY MEMORIAL HOSPITAL
Provider Second Line Business Mailing Address:
921 EAST HWY 36
Provider Business Mailing Address City Name:
P.O BOX 349
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66967
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
178-528-2684
Provider Business Mailing Address Fax Number:
785-282-6331

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SMITH COUNTY MEMORIAL HOSPITAL
Provider Second Line Business Practice Location Address:
921 EAST HWY 36
Provider Business Practice Location Address City Name:
P.O BOX 349
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66967
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-282-6845
Provider Business Practice Location Address Fax Number:
785-282-6331
Provider Enumeration Date:
11/23/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WM0705X , with the licence number:  63535 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 63535 . This is a "NURSING LICENSE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".