Provider Demographics
NPI:1093530438
Name:SHURTS, MARIE
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:SHURTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-2820
Mailing Address - Country:US
Mailing Address - Phone:715-802-3664
Mailing Address - Fax:
Practice Address - Street 1:102 HARRISON ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-2820
Practice Address - Country:US
Practice Address - Phone:715-802-3664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant