Provider Demographics
NPI:1013688597
Name:HIRTZ, REBECCA LYNN (FNP-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:HIRTZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2480 ROSEWOOD N
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-5003
Mailing Address - Country:US
Mailing Address - Phone:989-775-3823
Mailing Address - Fax:810-275-0307
Practice Address - Street 1:2480 ROSEWOOD N
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-5003
Practice Address - Country:US
Practice Address - Phone:989-775-3825
Practice Address - Fax:810-225-0307
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704317165363LF0000X
MI21124124613363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily