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General NPI Number Information
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NPI Number | 1619959343
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Entity Type | Individual
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Provider Name | KELLY J HIRSCH FNP
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Gender | Female
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Dates
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Enumeration Date | 11/17/2005
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 3 TECHNOLOGY PL
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City | HOMER
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State | NY
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Zip | 13077-1526
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Country | US
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Telephone | 607-753-3774
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Fax | 607-753-3947
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Provider Business Mailing Address
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Address Line | 85 S WEST ST
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City | HOMER
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State | NY
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Zip | 13077-1542
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Country | US
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Telephone | 607-753-3797
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Fax | 607-218-6708
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | F381523 1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 334759
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License Number State | NY
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