MEDICARE: TAMMY BELLE STARR-EVANS

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	163W00000X	Registered Nurse	4704216670	MI

General Provider Information

NPI Number	:	1841940079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMY BELLE STARR-EVANS

Provider Business Mailing Address
First Line	:	15268 MYERS LAKE AVE NE
Second Line	:
City	:	CEDAR SPRINGS
State	:	MI
Zip	:	49319-9728
Country	:	US
Telephone Number	:	616-648-0748
Fax Number	:

Provider Business Practice Location Address
First Line	:	15268 MYERS LAKE AVE NE
Second Line	:
City	:	CEDAR SPRINGS
State	:	MI
Zip	:	49319-9728
Country	:	US
Telephone Number	:	616-648-0748
Fax Number	:

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

Provider Enumeration Date	:	03/29/2022
Last Update Date	:	03/29/2022

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Directions to “ TAMMY BELLE STARR-EVANS ” Practice Location

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