Provider Demographics
NPI:1902152820
Name:KURTZ, LINDSAY NICOLE
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:NICOLE
Last Name:KURTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 S LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:BARNESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43713-1348
Mailing Address - Country:US
Mailing Address - Phone:740-238-0790
Mailing Address - Fax:
Practice Address - Street 1:224 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:BARNESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43713-1348
Practice Address - Country:US
Practice Address - Phone:740-238-0790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-29
Last Update Date:2012-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.149472-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse