Provider Demographics
NPI:1053903625
Name:URBIS, KATHLEEN NIMIINANGOS (FNP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:NIMIINANGOS
Last Name:URBIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MIDWAY DR
Mailing Address - Street 2:
Mailing Address - City:NEGAUNEE
Mailing Address - State:MI
Mailing Address - Zip Code:49866-9683
Mailing Address - Country:US
Mailing Address - Phone:720-810-4602
Mailing Address - Fax:
Practice Address - Street 1:105 MIDWAY DR
Practice Address - Street 2:
Practice Address - City:NEGAUNEE
Practice Address - State:MI
Practice Address - Zip Code:49866-9683
Practice Address - Country:US
Practice Address - Phone:720-810-4602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704339099363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily