Provider Demographics
NPI:1902339211
Name:PAHL, URSULA (RN)
Entity Type:Individual
Prefix:
First Name:URSULA
Middle Name:
Last Name:PAHL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 JFK DR
Mailing Address - Street 2:SUITE 118
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-1146
Mailing Address - Country:US
Mailing Address - Phone:561-812-2000
Mailing Address - Fax:561-423-0822
Practice Address - Street 1:110 JFK DR
Practice Address - Street 2:SUITE 118
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-1146
Practice Address - Country:US
Practice Address - Phone:561-812-2000
Practice Address - Fax:561-423-0822
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9449396163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)