Provider Demographics
NPI:1962124271
Name:KRUSZEWSKI, MARY KATHRYN TURTURRO (CPNP-PC)
Entity type:Individual
Prefix:
First Name:MARY KATHRYN
Middle Name:TURTURRO
Last Name:KRUSZEWSKI
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:MARY KATHRYN
Other - Middle Name:RUTH
Other - Last Name:TURTURRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16747 US HIGHWAY 17 STE 114
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-3086
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16747 US HIGHWAY 17 STE 114
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-3086
Practice Address - Country:US
Practice Address - Phone:910-777-2013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5016901363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics