MEDICARE: MRS. SUSAN C. STARKEL R.N.

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	163WS0200X	School Registered Nurse	RN027250	AZ

General Provider Information

NPI Number	:	1578624805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN C. STARKEL R.N.

Provider Business Mailing Address
First Line	:	450 SOUTH 13 WEST
Second Line	:
City	:	SAINT JOHNS
State	:	AZ
Zip	:	85936
Country	:	US
Telephone Number	:	928-337-4435
Fax Number	:	928-337-4930

Provider Business Practice Location Address
First Line	:	450 SOUTH 13 WEST
Second Line	:
City	:	SAINT JOHNS
State	:	AZ
Zip	:	85936
Country	:	US
Telephone Number	:	928-337-4435
Fax Number	:	928-337-4930

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

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	07/08/2007

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