Provider Demographics
NPI:1962433623
Name:URLAUB, CATHERINE R (PAC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:R
Last Name:URLAUB
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:R
Other - Last Name:URLAUB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6001
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58108-6001
Mailing Address - Country:US
Mailing Address - Phone:701-364-3300
Mailing Address - Fax:701-364-8906
Practice Address - Street 1:801 BROADWAY N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-3641
Practice Address - Country:US
Practice Address - Phone:701-234-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDPAC0307363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND854663100Medicaid
ND0118330OtherMEDICA #
ND137122OtherUCARE #
ND845S8UROtherMNBS #
ND0118329OtherMEDICA #
ND2155910OtherAMERICA'S PPO/ARAZ #
ND24645OtherNDBS #
NDDA9011041360OtherPREFERRED ONE #
NDHP43172OtherHEALHTPARTNERS #
ND0118330OtherMEDICA #
ND137122OtherUCARE #
ND24645OtherNDBS #
ND845S8UROtherMNBS #