Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 1-136603 | AL |
NPI | 1144714429 |
---|---|
Provider Name | Kayla Lynn Urban |
First Address | Athens, AL 35613-8193 |
Second Address | Huntsville, AL 35801-4470 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2018 |
Last Update Date | 19/06/2018 |