Provider Demographics
NPI:1891920203
Name:STARLING, SHANELL M
Entity Type:Individual
Prefix:MRS
First Name:SHANELL
Middle Name:M
Last Name:STARLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHANELL
Other - Middle Name:M
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:78D GRECIAN GARDENS DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626
Mailing Address - Country:US
Mailing Address - Phone:585-355-5462
Mailing Address - Fax:
Practice Address - Street 1:78D GRECIAN GARDENS DRIVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626
Practice Address - Country:US
Practice Address - Phone:585-355-5462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-29
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263811-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse