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NPI Code Detail

MEDICARE: KATHLEEN M. HURAYT F.N.P.

MEDICARE: KATHLEEN M. HURAYT F.N.P.
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
1363LF0000XFamily Nurse Practitioner2003013076MO
2363LF0000XFamily Nurse PractitionerA108719IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558365924
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN M. HURAYT F.N.P.
Provider Business Mailing Address
First Line : 114 E SOUTH HILLS DR
Second Line :
City : MARYVILLE
State : MO
Zip : 64468-2659
Country : US
Telephone Number : 660-562-2525
Fax Number : 660-562-4308
Provider Business Practice Location Address
First Line : 114 E SOUTH HILLS DR
Second Line :
City : MARYVILLE
State : MO
Zip : 64468-2659
Country : US
Telephone Number : 660-562-2525
Fax Number : 660-562-4308
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 07/09/2007

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