Healthcare Provider Details

I. General information

NPI: 1417217746
Provider Name (Legal Business Name): ANDREA R. KURZ DO, MHED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANDREA RENEE PENDLETON

II. Dates (important events)

Enumeration Date: 05/21/2012
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 N MAIN ST STE B
BELLEVUE ID
83313-5268
US

IV. Provider business mailing address

PO BOX 553
BELLEVUE ID
83313-0553
US

V. Phone/Fax

Practice location:
  • Phone: 208-218-8989
  • Fax: 833-373-0292
Mailing address:
  • Phone: 208-404-6402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberO-1377
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: