Provider Demographics
NPI:1821153388
Name:KURTS, JENNY COLEMAN (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:COLEMAN
Last Name:KURTS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 E SUNFLOWER RD STE 500
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-2837
Mailing Address - Country:US
Mailing Address - Phone:662-441-3978
Mailing Address - Fax:662-441-2548
Practice Address - Street 1:903 E SUNFLOWER RD STE 500
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-2837
Practice Address - Country:US
Practice Address - Phone:662-441-3978
Practice Address - Fax:662-441-2548
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR852854363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01681707Medicaid
MS01681707Medicaid