=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275041139
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAIGE PARKER KIRSCHT MSN, APRN, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/12/2018
-----------------------------------------------------
Last Update Date | 05/17/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10775 PIONEER TRL STE 215
-----------------------------------------------------
City | TRUCKEE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 96161-0234
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-424-4266
-----------------------------------------------------
Fax | 415-520-6633
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8300 ESTERS BLVD STE 900
-----------------------------------------------------
City | IRVING
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75063-2233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-424-4266
-----------------------------------------------------
Fax | 415-520-6633
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 95028304
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APRN11013389
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | AP136208
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------