Provider Demographics
NPI:1891347464
Name:BURESH, KELLI ANN (DNP ARNP AGPCNP-C)
Entity Type:Individual
Prefix:DR
First Name:KELLI
Middle Name:ANN
Last Name:BURESH
Suffix:
Gender:F
Credentials:DNP ARNP AGPCNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 BRENTWOOD PL
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-3720
Mailing Address - Country:US
Mailing Address - Phone:641-751-8039
Mailing Address - Fax:
Practice Address - Street 1:55 CENTRAL IOWA DR
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-4705
Practice Address - Country:US
Practice Address - Phone:641-754-8039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAHI55243363LG0600X, 363LA2200X
IAH155243363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care