Healthcare Provider Details

I. General information

NPI: 1225063225
Provider Name (Legal Business Name): DEBORAH JOAN STARR C.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 03/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 BATA BLVD SUITE A
BELCAMP MD
21017-1420
US

IV. Provider business mailing address

103 BATA BLVD SUITE A
BELCAMP MD
21017-1420
US

V. Phone/Fax

Practice location:
  • Phone: 410-575-6611
  • Fax: 410-575-6018
Mailing address:
  • Phone: 410-575-6611
  • Fax: 410-575-6018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR076792
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: