MEDICARE: MARIE A HIRSCH RN, CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	SP008535	PA
2	363LF0000X	Family Nurse Practitioner	001343	CT

General Provider Information

NPI Number	:	1588642961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE A HIRSCH RN, CRNP

Provider Business Mailing Address
First Line	:	6831 REYNOLDS ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15208-2615
Country	:	US
Telephone Number	:	412-362-1547
Fax Number	:

Provider Business Practice Location Address
First Line	:	UPMC SHADYSIDE SCHOOL OF NURSING
Second Line	:	5900 BAUM BLVD
City	:	PITTSBURGH
State	:	PA
Zip	:	15206-3808
Country	:	US
Telephone Number	:	412-623-1670
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	07/09/2007

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