Provider Demographics
NPI:1598958738
Name:KURKA, ANN LOUISE
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:LOUISE
Last Name:KURKA
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 1:700 8TH AVE W STE 101
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-4737
Mailing Address - Country:US
Mailing Address - Phone:941-776-4000
Mailing Address - Fax:941-845-4963
Practice Address - Street 1:300 RIVERSIDE DR E STE 2010
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1023
Practice Address - Country:US
Practice Address - Phone:941-405-1170
Practice Address - Fax:941-405-1175
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9402749363LF0000X
HI2197363LP2300X
FLARNP9402749363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06471737Medicaid
LA1888885Medicaid
LA1888885Medicaid