Provider Demographics
NPI:1467925388
Name:SCHURKE-BATSON, KELLY MARIE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:MARIE
Last Name:SCHURKE-BATSON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:MARIE
Other - Last Name:SCHURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25897 HIGHWAY A
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:MO
Mailing Address - Zip Code:64673-4690
Mailing Address - Country:US
Mailing Address - Phone:660-953-0136
Mailing Address - Fax:
Practice Address - Street 1:101 MAIN STREET
Practice Address - Street 2:
Practice Address - City:LINEVILLE
Practice Address - State:IA
Practice Address - Zip Code:50147-8517
Practice Address - Country:US
Practice Address - Phone:641-876-2070
Practice Address - Fax:641-876-2458
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-03
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007032679163W00000X
IAA155691363LF0000X
MO2019000931363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse