Healthcare Provider Details

I. General information

NPI: 1639516586
Provider Name (Legal Business Name): MARCIA SUSAN STARKMAN APRN, MSN, PMHCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2013
Last Update Date: 05/30/2021
Certification Date: 05/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 E HAZZARD ST
PHILADELPHIA PA
19125-1307
US

IV. Provider business mailing address

3225 N HIATUS RD UNIT 450958
FORT LAUDERDALE FL
33345-8450
US

V. Phone/Fax

Practice location:
  • Phone: 954-440-5141
  • Fax: 954-906-6466
Mailing address:
  • Phone: 954-440-5141
  • Fax: 954-908-6466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberRN9301357
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN9301357
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License NumberCNS000309
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberCNS000309
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: