Provider Demographics
NPI:1902685274
Name:HERSHBERGER, KIRA LYNN (DNP, FNP, APRN, RN)
Entity Type:Individual
Prefix:DR
First Name:KIRA
Middle Name:LYNN
Last Name:HERSHBERGER
Suffix:
Gender:F
Credentials:DNP, FNP, APRN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 AVENUE B APT 3
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-4707
Mailing Address - Country:US
Mailing Address - Phone:805-729-6964
Mailing Address - Fax:
Practice Address - Street 1:3440 LOMITA BLVD STE 427
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4896
Practice Address - Country:US
Practice Address - Phone:310-325-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027395363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily