Provider Demographics
NPI:1457691958
Name:ANDERSON, KURT ALBIN (MBA, MSN, APN, NP-C)
Entity Type:Individual
Prefix:MR
First Name:KURT
Middle Name:ALBIN
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MBA, MSN, APN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1123
Mailing Address - Street 2:
Mailing Address - City:TUCKERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-5123
Mailing Address - Country:US
Mailing Address - Phone:609-296-7945
Mailing Address - Fax:
Practice Address - Street 1:12 EDWARDS CT
Practice Address - Street 2:
Practice Address - City:LITTLE EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08087-3643
Practice Address - Country:US
Practice Address - Phone:609-296-7945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00418600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily