MEDICARE: MRS. ABBY MICHELLE STARSTROM ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	RN234946	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316910110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ABBY MICHELLE STARSTROM ARNP

Provider Business Mailing Address
First Line	:	1354 PEPPERGRASS TRL NW
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-7875
Country	:	US
Telephone Number	:	904-237-8456
Fax Number	:

Provider Business Practice Location Address
First Line	:	2655 DALLAS HWY SW STE 340
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30064-7518
Country	:	US
Telephone Number	:	678-797-9800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	01/07/2024

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