Provider Demographics
NPI:1265106991
Name:KURECKI, TAMMY (APRN)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:KURECKI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 LAMBETH CIR
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-1643
Mailing Address - Country:US
Mailing Address - Phone:941-587-4689
Mailing Address - Fax:
Practice Address - Street 1:158 ZILLICOA ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1079
Practice Address - Country:US
Practice Address - Phone:828-254-9494
Practice Address - Fax:828-250-0890
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2024-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11014727363LP0808X
FL11014727363LF0000X
NC5021052363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily