Provider Demographics
NPI:1194814798
Name:HIRSCH, SUE C (GNP, BC)
Entity Type:Individual
Prefix:MRS
First Name:SUE
Middle Name:C
Last Name:HIRSCH
Suffix:
Gender:F
Credentials:GNP, BC
Other - Prefix:MRS
Other - First Name:SUE
Other - Middle Name:C
Other - Last Name:HAMILTON-HIRSCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN
Mailing Address - Street 1:1979 CHELSEA JO LN
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37876-7022
Mailing Address - Country:US
Mailing Address - Phone:865-277-6310
Mailing Address - Fax:865-277-6310
Practice Address - Street 1:375 HEDRICK DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-2920
Practice Address - Country:US
Practice Address - Phone:865-277-6310
Practice Address - Fax:865-277-6310
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNN045235363L00000X
TNAPN0000013185363LG0600X
TN13185363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1514863Medicaid
TN1522992Medicaid