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General NPI Number Information
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NPI Number | 1275867301
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Entity Type | Individual
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Provider Name | LISA MORIARTY KIRSCHNER NP
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Gender | Female
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Dates
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Enumeration Date | 09/22/2009
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 1559 SULLIVAN AVE
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-2712
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Country | US
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Telephone | 860-696-2450
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Fax | 860-696-2360
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Provider Business Mailing Address
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Address Line | 1559 SULLIVAN AVE
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-2712
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Country | US
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Telephone | 860-696-2350
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Fax | 860-696-2360
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4206
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License Number State | CT
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