Healthcare Provider Details

I. General information

NPI: 1972899730
Provider Name (Legal Business Name): DANIELLE M STARR AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6475 S YALE AVE STE 401
TULSA OK
74136-7818
US

IV. Provider business mailing address

6600 S YALE AVE STE 1200
TULSA OK
74136-3361
US

V. Phone/Fax

Practice location:
  • Phone: 918-502-9555
  • Fax: 918-502-9559
Mailing address:
  • Phone: 918-488-6045
  • Fax: 918-488-6098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number000742
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number301
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number001036
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number121
License Number StateNE
# 5
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number4696
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: