Healthcare Provider Details

I. General information

NPI: 1508200270
Provider Name (Legal Business Name): KATHLEEN L HURLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 S WOODS MILL RD
CHESTERFIELD MO
63017-3406
US

IV. Provider business mailing address

PO BOX 551420
FORT LAUDERDALE FL
33355-1420
US

V. Phone/Fax

Practice location:
  • Phone: 314-434-1500
  • Fax:
Mailing address:
  • Phone: 800-243-3839
  • Fax: 844-414-8291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA10152600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: