Provider Demographics
NPI:1083997605
Name:KURTZ, AMY LYNNE
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNNE
Last Name:KURTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNNE
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4466 BOLON CT
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-1803
Mailing Address - Country:US
Mailing Address - Phone:614-499-0993
Mailing Address - Fax:
Practice Address - Street 1:4466 BOLON CT
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1803
Practice Address - Country:US
Practice Address - Phone:614-499-0993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH373344163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse