Provider Demographics
NPI:1568536167
Name:HIRSCH, MICHELLE L (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:L
Last Name:HIRSCH
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:MRS
Other - First Name:MICHELLE
Other - Middle Name:L
Other - Last Name:NEHLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, FNP-C
Mailing Address - Street 1:7900 LEES SUMMIT RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64139-1236
Mailing Address - Country:US
Mailing Address - Phone:816-404-7000
Mailing Address - Fax:
Practice Address - Street 1:1439 S MINTER WAY
Practice Address - Street 2:
Practice Address - City:GRAIN VALLEY
Practice Address - State:MO
Practice Address - Zip Code:64029-9648
Practice Address - Country:US
Practice Address - Phone:816-404-6785
Practice Address - Fax:816-404-6724
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORN107419363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO423846914Medicaid
MO423846914Medicaid