Provider Demographics
NPI:1487709564
Name:WUERTZ, EDITH FAHYS (ARNP)
Entity type:Individual
Prefix:MS
First Name:EDITH
Middle Name:FAHYS
Last Name:WUERTZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:EDITH
Other - Middle Name:
Other - Last Name:FAHYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4800 ROWAN RD
Mailing Address - Street 2:THE HARBOR BAYCARE BEHAVIORAL HEALTH
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-5609
Mailing Address - Country:US
Mailing Address - Phone:727-483-5912
Mailing Address - Fax:727-376-3652
Practice Address - Street 1:8132 KING HELIE BLVD
Practice Address - Street 2:THE HARBOR BAY CARE BEHAVIORAL HEALTH
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:38653
Practice Address - Country:US
Practice Address - Phone:727-834-3959
Practice Address - Fax:727-816-1964
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9231383363LP0808X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health