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General NPI Number Information
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NPI Number | 1881033884
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Entity Type | Individual
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Provider Name | KIMBERLY M KURTZ
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Gender | Female
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Dates
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Enumeration Date | 06/23/2013
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Last Update Date | 08/21/2019
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Provider Practice Location Address
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Address Line | 45 2ND STREET PIKE STE 100
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City | SOUTHAMPTON
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State | PA
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Zip | 18966-3829
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Country | US
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Telephone | 215-478-5973
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Fax |
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Provider Business Mailing Address
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Address Line | 8321 RIDGEWAY ST
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City | PHILADELPHIA
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State | PA
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Zip | 19111-1957
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Country | US
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Telephone | 215-478-5973
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP012822
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License Number State | PA
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