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General NPI Number Information
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NPI Number | 1154868867
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Entity Type | Organization
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Legal Business Name | KRUPNICK HEALTHCARE, LLC
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Dates
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Enumeration Date | 01/20/2017
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5327 CRESCENT EDGE DR
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City | PRESCOTT
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State | AZ
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Zip | 86301-0105
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Country | US
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Telephone | 928-899-6919
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Fax | 928-277-1627
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Provider Business Mailing Address
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Address Line | 5327 CRESCENT EDGE DR
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City | PRESCOTT
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State | AZ
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Zip | 86301-0105
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Country | US
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Telephone | 928-899-6919
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Fax | 928-277-1627
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. KURT ANDREW KRUPNICK
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Credential | M.D
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Telephone | 928-899-6919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 42104
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License Number State | AZ
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