MEDICARE: ELIZABETH KURT FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0024171135	VA

General Provider Information

NPI Number	:	1356775738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH KURT FNP

Provider Business Mailing Address
First Line	:	3949 BURNING BUSH CT
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22033-2447
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	44055 RIVERSIDE PKWY STE 100
Second Line	:
City	:	LEESBURG
State	:	VA
Zip	:	20176-5155
Country	:	US
Telephone Number	:	703-858-8878
Fax Number	:	703-858-8170

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2013
Last Update Date	:	07/14/2022

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