Provider Demographics
NPI:1821128257
Name:STARR, ANNE LOUISE (RP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:LOUISE
Last Name:STARR
Suffix:
Gender:F
Credentials:RP
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:LOUISE
Other - Last Name:CARTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RP
Mailing Address - Street 1:316 ELLIOT ST
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-0242
Mailing Address - Country:US
Mailing Address - Phone:712-322-6448
Mailing Address - Fax:712-328-0990
Practice Address - Street 1:1801 VALLEY VIEW DRIVE
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503
Practice Address - Country:US
Practice Address - Phone:712-322-6448
Practice Address - Fax:712-328-0990
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA14889183500000X
NE8327183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist