Basic Information
| Provider Information | |||||||||
| NPI: | 1710191168 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KURITZ | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DNP, MPH, ANP, PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11 S CENTRAL AVE | ||||||||
| Address2: | APT 2218 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850042524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802292298 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11361 N 99TH AVE | ||||||||
| Address2: | SUITE 402 | ||||||||
| City: | PEORIA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853455470 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6026501212 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2007 | ||||||||
| LastUpdateDate: | 07/09/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | AP60050270 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LX0106X | AP60050270 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Occupational Health | 363LP0808X | AP5533 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LA2200X | AP5534 | AZ | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.