Provider Demographics
NPI:1710191168
Name:KURITZ, PATRICK M (DNP, MPH, ANP, PMHNP)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:M
Last Name:KURITZ
Suffix:
Gender:M
Credentials:DNP, MPH, ANP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 S CENTRAL AVE
Mailing Address - Street 2:APT 2218
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-2524
Mailing Address - Country:US
Mailing Address - Phone:480-229-2298
Mailing Address - Fax:
Practice Address - Street 1:11361 N 99TH AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-5470
Practice Address - Country:US
Practice Address - Phone:602-650-1212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2016-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60050270363LA2200X, 363LX0106X
AZAP5533363LP0808X
AZAP5534363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health