Healthcare Provider Details

I. General information

NPI: 1629984794
Provider Name (Legal Business Name): ELIZABETH KIRSCH SM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1621 W HIGHWAY 96
MANSFIELD AR
72944-9062
US

IV. Provider business mailing address

1621 W HIGHWAY 96
MANSFIELD AR
72944-9062
US

V. Phone/Fax

Practice location:
  • Phone: 908-433-9851
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: