Healthcare Provider Details

I. General information

NPI: 1902289655
Provider Name (Legal Business Name): MELISSA JEANNE KUREK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2015
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5087 N ROYAL DR STE B
TRAVERSE CITY MI
49684-6987
US

IV. Provider business mailing address

1105 SIXTH ST
TRAVERSE CITY MI
49684-2345
US

V. Phone/Fax

Practice location:
  • Phone: 231-935-0440
  • Fax: 231-935-0445
Mailing address:
  • Phone: 231-935-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704230389
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number4704230389
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: