Provider Demographics
NPI:1013612902
Name:KIRBY-SMITH, JESSICA (APN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:KIRBY-SMITH
Suffix:
Gender:
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 231
Mailing Address - Street 2:
Mailing Address - City:OCEANPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07757-0231
Mailing Address - Country:US
Mailing Address - Phone:732-861-6160
Mailing Address - Fax:
Practice Address - Street 1:44 SYCAMORE AVE STE 3D
Practice Address - Street 2:
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1242
Practice Address - Country:US
Practice Address - Phone:732-838-9326
Practice Address - Fax:732-605-5858
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF404845-01363LP0808X
NJ26NJ01472700363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health