Healthcare Provider Details

I. General information

NPI: 1699927822
Provider Name (Legal Business Name): CHRISTY RENEE KUTZ CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13640 N PLAZA DEL RIO BLVD STE 210
PEORIA AZ
85381-4846
US

IV. Provider business mailing address

13640 N PLAZA DEL RIO BLVD STE 210
PEORIA AZ
85381-4846
US

V. Phone/Fax

Practice location:
  • Phone: 623-285-1120
  • Fax:
Mailing address:
  • Phone: 623-285-1120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP009978
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP 3366
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: