Provider Demographics
NPI:1548592926
Name:MCKELVIN, STARLENE DELORES (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:STARLENE
Middle Name:DELORES
Last Name:MCKELVIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
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Mailing Address - Street 1:9123 SUNSET RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-3651
Mailing Address - Country:US
Mailing Address - Phone:410-733-4636
Mailing Address - Fax:410-842-4801
Practice Address - Street 1:4801 LIBERTY HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-7157
Practice Address - Country:US
Practice Address - Phone:410-733-4636
Practice Address - Fax:410-842-4801
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR100835363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily