Provider Demographics
NPI:1619248499
Name:KURTZ, CHERYL ANN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:ANN
Last Name:KURTZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:CHERYL
Other - Middle Name:ANN
Other - Last Name:PADDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:25 STRAUB RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4207
Mailing Address - Country:US
Mailing Address - Phone:585-410-1979
Mailing Address - Fax:
Practice Address - Street 1:25 STRAUB RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4207
Practice Address - Country:US
Practice Address - Phone:585-410-1979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY246218164W00000X
NY246218-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse