Provider Demographics
NPI:1114277308
Name:DAMIAN, STAR LYNN (RRT, RRT-SDS)
Entity Type:Individual
Prefix:
First Name:STAR
Middle Name:LYNN
Last Name:DAMIAN
Suffix:
Gender:F
Credentials:RRT, RRT-SDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 HORSE STABLE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-6780
Mailing Address - Country:US
Mailing Address - Phone:702-999-7931
Mailing Address - Fax:702-224-6907
Practice Address - Street 1:6900 N PECOS RD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89086-4400
Practice Address - Country:US
Practice Address - Phone:702-791-9000
Practice Address - Fax:702-224-6907
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12708238-5701227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered