Provider Demographics
NPI:1457858920
Name:KURTZ, ALEXANDRIA KRISTINE (DO)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:KRISTINE
Last Name:KURTZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ALEXANDRIA
Other - Middle Name:KRISTINE
Other - Last Name:ERICKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:6424 E GREENWAY PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2045
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4801 RIVERBEND RD STE 120A
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2613
Practice Address - Country:US
Practice Address - Phone:303-415-8641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0085302084P0800X
CODR.00689172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry