Healthcare Provider Details

I. General information

NPI: 1710191168
Provider Name (Legal Business Name): PATRICK M KURITZ DNP, MPH, ANP, PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 07/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11361 N 99TH AVE SUITE 402
PEORIA AZ
85345-5470
US

IV. Provider business mailing address

11 S CENTRAL AVE APT 2218
PHOENIX AZ
85004-2524
US

V. Phone/Fax

Practice location:
  • Phone: 602-650-1212
  • Fax:
Mailing address:
  • Phone: 480-229-2298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP60050270
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberAP60050270
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP5533
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP5534
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: