Provider Demographics
NPI:1548769334
Name:STARR, KARIN
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:
Last Name:STARR
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 1:7708 CALLE ARMONIA NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-2369
Mailing Address - Country:US
Mailing Address - Phone:505-615-8935
Mailing Address - Fax:
Practice Address - Street 1:10900 SAN JACINTO AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-5414
Practice Address - Country:US
Practice Address - Phone:505-298-5009
Practice Address - Fax:505-298-3840
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-69178163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM$$$$$$$$$Medicaid