Provider Demographics
NPI:1083218085
Name:DEPIANO, STAR EMERALD
Entity Type:Individual
Prefix:
First Name:STAR
Middle Name:EMERALD
Last Name:DEPIANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 12TH ST S APT 205
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-8205
Mailing Address - Country:US
Mailing Address - Phone:701-630-3094
Mailing Address - Fax:
Practice Address - Street 1:404 1ST ST NW LOT H
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:ND
Practice Address - Zip Code:58045-4113
Practice Address - Country:US
Practice Address - Phone:701-630-3094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide