Provider Demographics
NPI:1306414388
Name:STARMAN, OLIVIA
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:STARMAN
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 1:201 1/2 WEST PLUM ST.
Mailing Address - Street 2:
Mailing Address - City:DONIPHAN
Mailing Address - State:NE
Mailing Address - Zip Code:68832
Mailing Address - Country:US
Mailing Address - Phone:308-383-7783
Mailing Address - Fax:
Practice Address - Street 1:201 1/2 WEST PLUM ST.
Practice Address - Street 2:
Practice Address - City:DONIPHAN
Practice Address - State:NE
Practice Address - Zip Code:68832
Practice Address - Country:US
Practice Address - Phone:130-838-3778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE971224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant