Provider Demographics
NPI:1639347420
Name:KURTYKA, SANDRA DENISE (MSN CRNP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:DENISE
Last Name:KURTYKA
Suffix:
Gender:F
Credentials:MSN CRNP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN CRNP
Mailing Address - Street 1:111 ARRANDALE BLVD
Mailing Address - Street 2:CHESTER COUNTY PEDIATRICS
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341
Mailing Address - Country:US
Mailing Address - Phone:610-524-5437
Mailing Address - Fax:610-524-5645
Practice Address - Street 1:111 ARRANDALE BLVD
Practice Address - Street 2:CHESTER COUNTY PEDIATRICS
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341
Practice Address - Country:US
Practice Address - Phone:610-524-5437
Practice Address - Fax:610-524-5645
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009553363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner