Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 169114-30 | WI |
N | 363LW0102X | Nurse Practitioner - Women's Health | 194294-7 | MN |
NPI | 1013342658 |
---|---|
Provider Name | Jodi Lynn Kurtz |
First Address | Madison, WI 53711-1773 |
Second Address | Janesville, WI 53545-0221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2013 |
Last Update Date | 12/09/2013 |