Provider Demographics
NPI:1992256184
Name:URQUIOLA, MARIA EUGENIA (CNA)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:EUGENIA
Last Name:URQUIOLA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3835 VISCOUNT AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-6052
Mailing Address - Country:US
Mailing Address - Phone:901-365-1100
Mailing Address - Fax:901-365-2255
Practice Address - Street 1:1527 STONEWALL BLVD STE 1
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-1641
Practice Address - Country:US
Practice Address - Phone:901-365-1100
Practice Address - Fax:901-365-2255
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00171301376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN70003004Medicaid