MEDICARE: MRS. KELLY LEIGH KURTZ ARNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	834163	NV
2	363LA2200X	Adult Health Nurse Practitioner	308061	NY
3	363LA2200X	Adult Health Nurse Practitioner	95010236	CA
4	363L00000X	Nurse Practitioner	RN308026	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1275698284	OTHER		NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	Y03N2	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1275698284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KELLY LEIGH KURTZ ARNP-C

Provider Business Mailing Address
First Line	:	PO BOX 98978
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89193-8978
Country	:	US
Telephone Number	:	702-216-3346
Fax Number	:

Provider Business Practice Location Address
First Line	:	1372 PEACHTREE ST NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-3203
Country	:	US
Telephone Number	:	470-964-1700
Fax Number	:	678-288-5639

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	11/24/2025

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