Basic Information
| Provider Information | |||||||||
| NPI: | 1124580857 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KURZ | ||||||||
| FirstName: | ELINOR | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | ME | ||||||||
| PostalCode: | 039091099 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2073512478 | ||||||||
| FaxNumber: | 2073512216 | ||||||||
| Practice Location | |||||||||
| Address1: | 127 LONG SANDS RD | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | ME | ||||||||
| PostalCode: | 039091158 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2073513777 | ||||||||
| FaxNumber: | 2073513788 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2019 | ||||||||
| LastUpdateDate: | 05/06/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN54443 | ME | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | CNP191043 | ME | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | CNP191043 | 01 | ME | LICENSE | OTHER | MK5255167 | 01 | ME | DEA | OTHER |