Provider Demographics
NPI:1538029814
Name:KIRSCH, TRAVIS OWEN
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:OWEN
Last Name:KIRSCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19602 PARKER ST
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-6423
Mailing Address - Country:US
Mailing Address - Phone:402-960-0288
Mailing Address - Fax:
Practice Address - Street 1:19602 PARKER ST
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-6423
Practice Address - Country:US
Practice Address - Phone:402-960-0288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-18
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion