Provider Demographics
NPI:1417177478
Name:STARR, DEBRA K (APRN, BC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:K
Last Name:STARR
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Gender:F
Credentials:APRN, BC
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:354 W BOYLSTON ST
Mailing Address - Street 2:SUITE 224
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-2373
Mailing Address - Country:US
Mailing Address - Phone:508-756-0470
Mailing Address - Fax:508-756-0471
Practice Address - Street 1:354 W BOYLSTON ST
Practice Address - Street 2:SUITE 224
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-2373
Practice Address - Country:US
Practice Address - Phone:508-756-0470
Practice Address - Fax:508-756-0471
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA122682364SP0810X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0810XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Family
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPN0827OtherBC BS OF MASSACHUSETTS
MAM18884OtherBC BS OF MASSACHUSETTS