Provider Demographics
NPI:1578008025
Name:STARR, MELISSA MARIE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:MARIE
Last Name:STARR
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:MARIE
Other - Last Name:BADALAMENTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1051 SAINT CLAIR RIVER DR
Mailing Address - Street 2:
Mailing Address - City:ALGONAC
Mailing Address - State:MI
Mailing Address - Zip Code:48001-1457
Mailing Address - Country:US
Mailing Address - Phone:810-794-0348
Mailing Address - Fax:810-794-0439
Practice Address - Street 1:1051 SAINT CLAIR RIVER DR
Practice Address - Street 2:
Practice Address - City:ALGONAC
Practice Address - State:MI
Practice Address - Zip Code:48001-1457
Practice Address - Country:US
Practice Address - Phone:810-794-0348
Practice Address - Fax:810-794-0439
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-19
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704268965163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse