Provider Demographics
NPI:1245709583
Name:KIRCHHOFF, SARINA LYNNE
Entity type:Individual
Prefix:MRS
First Name:SARINA
Middle Name:LYNNE
Last Name:KIRCHHOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MACEDON
Mailing Address - State:NY
Mailing Address - Zip Code:14502-8988
Mailing Address - Country:US
Mailing Address - Phone:585-967-2447
Mailing Address - Fax:
Practice Address - Street 1:55 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MACEDON
Practice Address - State:NY
Practice Address - Zip Code:14502-8988
Practice Address - Country:US
Practice Address - Phone:585-967-2447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320119164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse