Healthcare Provider Details

I. General information

NPI: 1750799508
Provider Name (Legal Business Name): JENNIFER JILL STARR CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER JILL CASHORALI CNP

II. Dates (important events)

Enumeration Date: 07/24/2014
Last Update Date: 03/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 SOUTH ST SUITE 112
WARE MA
01082-1625
US

IV. Provider business mailing address

280 CHESTNUT ST 2ND FLOOR
SPRINGFIELD MA
01199-1619
US

V. Phone/Fax

Practice location:
  • Phone: 413-967-2040
  • Fax: 413-967-2044
Mailing address:
  • Phone: 413-794-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN2263977
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: