Provider Demographics
NPI:1922440577
Name:FORSYTHE, KIRSTEN M (CRNP)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:M
Last Name:FORSYTHE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KIRSTEN
Other - Middle Name:
Other - Last Name:KOSKINEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-2000
Mailing Address - Fax:717-812-2010
Practice Address - Street 1:1575 BANNISTER ST
Practice Address - Street 2:SUITE 1
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-4946
Practice Address - Country:US
Practice Address - Phone:717-812-2000
Practice Address - Fax:717-812-2010
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012978363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA320730Medicare PIN