Healthcare Provider Details

I. General information

NPI: 1922345248
Provider Name (Legal Business Name): RAVEN MELINA STARR MS, RN, AACNS-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2013
Last Update Date: 04/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13199 E MONTVIEW BLVD SUITE 400
AURORA CO
80045-7202
US

IV. Provider business mailing address

13199 E MONTVIEW BLVD SUITE 400
AURORA CO
80045-7202
US

V. Phone/Fax

Practice location:
  • Phone: 303-724-8207
  • Fax:
Mailing address:
  • Phone: 303-724-8207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number0193214
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number0193214
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number0193214
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License NumberAPN.0992674-CNS
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: