Provider Demographics
NPI:1003525932
Name:KURDZIEL, ALEXIS LAUREN (APRN CNM)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:LAUREN
Last Name:KURDZIEL
Suffix:
Gender:F
Credentials:APRN CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 GRACEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-3343
Mailing Address - Country:US
Mailing Address - Phone:734-497-0419
Mailing Address - Fax:
Practice Address - Street 1:2150 W CENTRAL AVE STE A
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3852
Practice Address - Country:US
Practice Address - Phone:419-291-2192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-18
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNM.0019545367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife