Provider Demographics
NPI:1447238464
Name:KURTH, KATHERINE M (RN NP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:M
Last Name:KURTH
Suffix:
Gender:F
Credentials:RN NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8674
Mailing Address - Street 2:1230 E MAIN ST MANKATO CLINIC LTD
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56002-8674
Mailing Address - Country:US
Mailing Address - Phone:507-625-1811
Mailing Address - Fax:
Practice Address - Street 1:1230 E MAIN ST
Practice Address - Street 2:MANKATO CLINIC AT MAIN STREET
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56002-8674
Practice Address - Country:US
Practice Address - Phone:507-625-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 126504 8363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN140177OtherUCARE
MN1747415OtherAMERICAS PPO
410849339 56001 C175OtherCHAMPUS
MN276923900Medicaid
MN63B85KUOtherBCBS
MNHP31625OtherHEALTH PARTNERS
500017110OtherRR MEDICARE
MNNA2951025467OtherPREFERRED ONE
MN0105371OtherMEDICA
MN276923900Medicaid
410849339 56001 C175OtherCHAMPUS