Provider Demographics
NPI:1487849410
Name:STARR, JANE ANNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:ANNE
Last Name:STARR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:801 HAZEN STREET SUITE C
Mailing Address - City:PAW PAW
Mailing Address - State:MI
Mailing Address - Zip Code:49079-0249
Mailing Address - Country:US
Mailing Address - Phone:269-657-5574
Mailing Address - Fax:269-657-3474
Practice Address - Street 1:430 BANGOR ROAD
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MI
Practice Address - Zip Code:49064
Practice Address - Country:US
Practice Address - Phone:269-674-4600
Practice Address - Fax:269-674-4126
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704155690163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse