1871561514 NPI number — GRACE ELLEN URQUHART ARNP

Table of content: GRACE ELLEN URQUHART ARNP (NPI 1871561514)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871561514 NPI number — GRACE ELLEN URQUHART ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
URQUHART
Provider First Name:
GRACE
Provider Middle Name:
ELLEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
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:
1871561514
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2067 WESTERN PECAN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW BRAUNFELS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78130-2762
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-948-9669
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2158 LAWSON CREEK RD APT D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOUGLAS
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99824-5024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
85-994-8966
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/09/2006

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: 363L00000X , with the licence number:  4473P , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 1220 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 78014636 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000363981 . This is a "BCBS HHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7229645 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000385627 . This is a "BCBS BPC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1221653 . This is a "CHA HHC" identifier . This identifiers is of the category "OTHER".




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