Provider Demographics
NPI:1235230806
Name:KIRSCH, WHITNEY J (PA-C)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:J
Last Name:KIRSCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:J
Other - Last Name:WINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2605 N LEBANON ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-1476
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6085 HEARTLAND DR STE 205
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-4433
Practice Address - Country:US
Practice Address - Phone:317-768-2200
Practice Address - Fax:317-768-2209
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10000905A363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300035950Medicaid
INQ76693Medicare UPIN