MEDICARE: ASHLEY KOCUREK FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	1177969	TX

General Provider Information

NPI Number	:	1225851876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY KOCUREK FNP-C

Provider Business Mailing Address
First Line	:	40 EAST AVE
Second Line	:
City	:	SCHULENBURG
State	:	TX
Zip	:	78956-1611
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 EAST AVE
Second Line	:
City	:	SCHULENBURG
State	:	TX
Zip	:	78956-1611
Country	:	US
Telephone Number	:	979-743-3520
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2024
Last Update Date	:	11/04/2024

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