Provider Demographics
NPI:1881046381
Name:URBAN, CARRIE EASTON (DNP, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:EASTON
Last Name:URBAN
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:MS
Other - First Name:CARRIE
Other - Middle Name:ANN
Other - Last Name:EASTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, PMHNP-BC
Mailing Address - Street 1:PSC 482 BOX 98
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96362-0099
Mailing Address - Country:US
Mailing Address - Phone:011803-150-3831
Mailing Address - Fax:
Practice Address - Street 1:PSC 482
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96362-9998
Practice Address - Country:US
Practice Address - Phone:01181098-971-7135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024172902363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health