Provider Demographics
NPI:1467127811
Name:KURTENBACH, KARI ANN
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:ANN
Last Name:KURTENBACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47794 JULIE DR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-8227
Mailing Address - Country:US
Mailing Address - Phone:605-929-8842
Mailing Address - Fax:
Practice Address - Street 1:4500 N LEWIS AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-7111
Practice Address - Country:US
Practice Address - Phone:605-322-4236
Practice Address - Fax:605-322-2097
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP002069363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner