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General NPI Number Information
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NPI Number | 1255871349
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Entity Type | Individual
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Provider Name | MICHELE STARR PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/08/2017
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Last Update Date | 03/08/2017
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Provider Practice Location Address
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Address Line | 409 NW 39TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73118-8415
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Country | US
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Telephone | 405-820-7249
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Fax | 405-951-9872
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Provider Business Mailing Address
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Address Line | 409 NW 39TH STREET
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City | OKLAHOMA CITY
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State | OK
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Zip | 73118-8606
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Country | US
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Telephone | 405-820-7249
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Fax | 405-951-9872
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 387
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License Number State | OK
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