Provider Demographics
NPI:1407970122
Name:STARNES, DANIELLE N (PA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:N
Last Name:STARNES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 PERIMETER CENTER TER NE
Mailing Address - Street 2:SUITE 900
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346-1227
Mailing Address - Country:US
Mailing Address - Phone:877-513-7274
Mailing Address - Fax:877-513-7274
Practice Address - Street 1:400 PERIMETER CENTER TER NE
Practice Address - Street 2:SUITE 900
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-1227
Practice Address - Country:US
Practice Address - Phone:877-513-7274
Practice Address - Fax:877-513-7274
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006106363A00000X
VA0110001862363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003109258BMedicaid
GAP01062327OtherRR MEDICARE
GA003109258BMedicaid
VAP73986Medicare UPIN
GA20297I8269Medicare PIN