Provider Demographics
NPI:1528069572
Name:HIRST, JOANNE (ANP)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:
Last Name:HIRST
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ST. MARY'S HOSPITAL AT AMSTERDAM
Mailing Address - Street 2:427 GUY PARK AVENUE - PRIMARY CARE
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-1054
Mailing Address - Country:US
Mailing Address - Phone:518-841-7430
Mailing Address - Fax:518-841-7121
Practice Address - Street 1:101 W MAIN ST
Practice Address - Street 2:ST. MARY'S FAMILY HEALTH CTR. AT CANAJOHARIE
Practice Address - City:CANAJOHARIE
Practice Address - State:NY
Practice Address - Zip Code:13317-1114
Practice Address - Country:US
Practice Address - Phone:518-673-2573
Practice Address - Fax:518-673-2781
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF301996-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02327282Medicaid
S57175Medicare UPIN
NYCC4155Medicare ID - Type Unspecified