Healthcare Provider Details

I. General information

NPI: 1992510028
Provider Name (Legal Business Name): LAURIE STARR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2025
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4013 CR 4055
INDEPENDENCE KS
67301-7810
US

IV. Provider business mailing address

4013 CR 4055
INDEPENDENCE KS
67301-7810
US

V. Phone/Fax

Practice location:
  • Phone: 620-636-1332
  • Fax:
Mailing address:
  • Phone: 620-636-1332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number13122272041
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: