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General NPI Number Information
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NPI Number | 1790294460
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Entity Type | Individual
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Provider Name | ADAM TYLER KURTZ PMHNP
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Gender | Male
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 1634 11TH ST
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City | PORTSMOUTH
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State | OH
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Zip | 45662-4526
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Country | US
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Telephone | 740-355-7102
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Fax | 740-353-3083
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Provider Business Mailing Address
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Address Line | 1634 11TH ST
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City | PORTSMOUTH
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State | OH
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Zip | 45662-4526
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Country | US
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Telephone | 740-355-7102
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Fax | 740-355-3083
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0037952
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | RN.455453
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN.455453
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License Number State | OH
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