Provider Demographics
NPI:1225462062
Name:STUTSMAN, KURTIS BRENT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KURTIS
Middle Name:BRENT
Last Name:STUTSMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23421 ROAD 200
Mailing Address - Street 2:
Mailing Address - City:LINDSAY
Mailing Address - State:CA
Mailing Address - Zip Code:93247-9748
Mailing Address - Country:US
Mailing Address - Phone:559-799-1388
Mailing Address - Fax:559-562-1115
Practice Address - Street 1:305 E CENTER AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-6331
Practice Address - Country:US
Practice Address - Phone:559-737-4792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69564183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist