Healthcare Provider Details

I. General information

NPI: 1538528104
Provider Name (Legal Business Name): GWENDOLYN KURTZ-STENGER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2016
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32605 W 12 MILE RD STE 195
FARMINGTON HILLS MI
48334-3390
US

IV. Provider business mailing address

77 MONROE CENTE ST. NW
GRAND RAPIDS MI
49503
US

V. Phone/Fax

Practice location:
  • Phone: 313-306-2023
  • Fax:
Mailing address:
  • Phone: 269-716-6606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number4704216263
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704216263
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number4704216263
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: