Provider Demographics
NPI:1568059194
Name:KURTZ, SOPHIE A
Entity Type:Individual
Prefix:MRS
First Name:SOPHIE
Middle Name:A
Last Name:KURTZ
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 1:101 ALBERT ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44444-1048
Mailing Address - Country:US
Mailing Address - Phone:133-087-2127
Mailing Address - Fax:
Practice Address - Street 1:101 ALBERT ST
Practice Address - Street 2:
Practice Address - City:NEWTON FALLS
Practice Address - State:OH
Practice Address - Zip Code:44444-1048
Practice Address - Country:US
Practice Address - Phone:133-087-2127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty