Provider Demographics
NPI:1508470592
Name:KURTZ, HALLIE (DNP, ARNP)
Entity Type:Individual
Prefix:
First Name:HALLIE
Middle Name:
Last Name:KURTZ
Suffix:
Gender:F
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7530 164TH AVE. NE
Mailing Address - Street 2:SUITE A215
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-7809
Mailing Address - Country:US
Mailing Address - Phone:425-855-9292
Mailing Address - Fax:
Practice Address - Street 1:7530 164TH AVE. NE
Practice Address - Street 2:SUITE A215
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7809
Practice Address - Country:US
Practice Address - Phone:425-855-9292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-07
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60810527163WP0200X
WAAP61448112363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics