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1538528104 NPI number — GWENDOLYN KURTZ-STENGER NP

NPI Number: 1538528104
Health Care Provider/Practitioner: GWENDOLYN KURTZ-STENGER NP

Information about “1538528104” NPI (GWENDOLYN KURTZ-STENGER NP) exists in 1538528104 in HTML format HTML  |  1538528104 in plain Text format TXT  |  1538528104 in PDF (Portable Document Format) PDF  |  1538528104 in an XML format XML  formats.

NPI Number : 1538528104 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1538528104",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KURTZ-STENGER",
    "FirstName": "GWENDOLYN",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "77 MONROE CENTE ST. NW",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GRAND RAPIDS",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "49503",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "269-716-6606",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "32605 W 12 MILE RD STE 195",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FARMINGTON HILLS",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48334-3390",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "313-306-2023",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/11/2016",
    "LastUpdateDate": "05/19/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207QG0300X",
          "TaxonomyName": "Geriatric Medicine (Family Medicine) Physician",
          "LicenseNumber": "4704216263",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2200X",
          "TaxonomyName": "Adult Health Nurse Practitioner",
          "LicenseNumber": "4704216263",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LG0600X",
          "TaxonomyName": "Gerontology Nurse Practitioner",
          "LicenseNumber": "4704216263",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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