Provider Demographics
NPI:1376957548
Name:GURKOVICH, LINDSEY (PA)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:GURKOVICH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 MARTY AVE
Mailing Address - Street 2:APT 3
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66103-2960
Mailing Address - Country:US
Mailing Address - Phone:443-340-3327
Mailing Address - Fax:
Practice Address - Street 1:5250 W 94TH TER
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66207-2502
Practice Address - Country:US
Practice Address - Phone:913-451-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant