Provider Demographics
NPI:1235996323
Name:STARR, ANNA (MS, RD, LMNT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:STARR
Suffix:
Gender:F
Credentials:MS, RD, LMNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5935 TANGEMAN TER
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-1753
Mailing Address - Country:US
Mailing Address - Phone:515-333-3398
Mailing Address - Fax:
Practice Address - Street 1:7501 S 27TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-4802
Practice Address - Country:US
Practice Address - Phone:402-482-6371
Practice Address - Fax:402-481-6338
Is Sole Proprietor?:No
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1753133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered