Provider Demographics
NPI:1861531303
Name:KURTH, PAMELA J (CRNFA)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:KURTH
Suffix:
Gender:F
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 ILLINOIS DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-3848
Mailing Address - Country:US
Mailing Address - Phone:239-643-2561
Mailing Address - Fax:239-643-5911
Practice Address - Street 1:1121 ILLINOIS DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3848
Practice Address - Country:US
Practice Address - Phone:239-643-2561
Practice Address - Fax:239-643-5911
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1747952163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY5282OtherBCBS