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General NPI Number Information
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NPI Number | 1407511652
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Entity Type | Individual
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Provider Name | MARY KATHLEEN SCHURK WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/02/2021
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Last Update Date | 11/02/2021
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Provider Practice Location Address
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Address Line | 4331 LINDELL BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63108-2701
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Country | US
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Telephone | 314-207-3163
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Fax |
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Provider Business Mailing Address
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Address Line | 421 FAIRLAWN AVE
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City | WEBSTER GROVES
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State | MO
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Zip | 63119-2614
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Country | US
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Telephone | 314-780-1278
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN079984
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License Number State | MO
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