Provider Demographics
NPI:1932296654
Name:KURZ, KRISTY BERNARDI (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:BERNARDI
Last Name:KURZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14618 MICHENER TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-6458
Mailing Address - Country:US
Mailing Address - Phone:321-206-3646
Mailing Address - Fax:
Practice Address - Street 1:6100 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3437
Practice Address - Country:US
Practice Address - Phone:407-482-6377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9180976363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL15187901OtherCITRUS PROVIDER NUMBER
FL308173700Medicaid
FL380123OtherWELLCARE
FL317541OtherAMERIGROUP PROVIDER NUMBE