Provider Demographics
NPI:1639594930
Name:US STAR NURSING
Entity Type:Organization
Organization Name:US STAR NURSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:TARSHA
Authorized Official - Middle Name:CARTER
Authorized Official - Last Name:AMBEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-304-2043
Mailing Address - Street 1:7 PRIMROSE LN
Mailing Address - Street 2:48 EAST WOODLAWN STREET
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-4877
Mailing Address - Country:US
Mailing Address - Phone:601-304-2043
Mailing Address - Fax:
Practice Address - Street 1:7 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-4877
Practice Address - Country:US
Practice Address - Phone:601-304-2043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-23
Last Update Date:2014-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR863813163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Multi-Specialty