Provider Demographics
NPI:1669770814
Name:WINDFELDT, KURT M (LPN)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:M
Last Name:WINDFELDT
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2355 LOIS DR
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-1418
Mailing Address - Country:US
Mailing Address - Phone:614-871-1725
Mailing Address - Fax:
Practice Address - Street 1:2355 LOIS DR
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-1418
Practice Address - Country:US
Practice Address - Phone:614-871-1725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.142284-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse