Provider Demographics
NPI:1093803926
Name:KIRWAN, KRISTEN HUPPERT (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:HUPPERT
Last Name:KIRWAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 CANTRELL AVE.
Mailing Address - Street 2:MSC 7901
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801
Mailing Address - Country:US
Mailing Address - Phone:540-568-6178
Mailing Address - Fax:540-568-6176
Practice Address - Street 1:235 CANTRELL AVE.
Practice Address - Street 2:MSC 7901 JMU HEALTH CENTER
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22807
Practice Address - Country:US
Practice Address - Phone:540-564-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001159792163W00000X
VA0024165022363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA015763S45Medicare PIN