Healthcare Provider Details

I. General information

NPI: 1215323514
Provider Name (Legal Business Name): KATHLEEN SCHURR DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 02/26/2023
Certification Date: 02/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 NEW WAVERLY PL STE 200
CARY NC
27518-7414
US

IV. Provider business mailing address

PO BOX 18563
RALEIGH NC
27619-8563
US

V. Phone/Fax

Practice location:
  • Phone: 919-859-5955
  • Fax: 919-859-5659
Mailing address:
  • Phone: 919-782-1806
  • Fax: 919-782-4756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102205172
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2022-00857
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: