Provider Demographics
NPI:1245564160
Name:STARBUCK, MANDY FIELDS (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MANDY
Middle Name:FIELDS
Last Name:STARBUCK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 W ARLINGTON BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5727
Mailing Address - Country:US
Mailing Address - Phone:252-757-3333
Mailing Address - Fax:252-752-1786
Practice Address - Street 1:2090 W ARLINGTON BLVD STE A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5727
Practice Address - Country:US
Practice Address - Phone:252-757-3333
Practice Address - Fax:252-752-1786
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004502363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner