Healthcare Provider Details
I. General information
NPI: 1699378224
Provider Name (Legal Business Name): KELSEY HELEN STAREK
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/17/2020
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5 NEPONSET ST
WORCESTER MA
01606-2714
US
IV. Provider business mailing address
5 NEPONSET ST
WORCESTER MA
01606-2714
US
V. Phone/Fax
- Phone: 508-368-7887
- Fax: 508-792-4392
- Phone: 508-368-7887
- Fax: 508-792-4392
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | RN2316416 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: