Provider Demographics
NPI:1598582694
Name:ACHTERKAMP-HURKMANS, WIES (NP)
Entity type:Individual
Prefix:
First Name:WIES
Middle Name:
Last Name:ACHTERKAMP-HURKMANS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 6TH AVE APT 811
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-4969
Mailing Address - Country:US
Mailing Address - Phone:248-730-2189
Mailing Address - Fax:
Practice Address - Street 1:240 W 73RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2700
Practice Address - Country:US
Practice Address - Phone:212-362-4742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-21
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF433100-01363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care