Provider Demographics
NPI:1972899730
Name:STARR, DANIELLE M (AUD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:M
Last Name:STARR
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3361
Mailing Address - Country:US
Mailing Address - Phone:918-488-6045
Mailing Address - Fax:918-488-6098
Practice Address - Street 1:6475 S YALE AVE STE 401
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7818
Practice Address - Country:US
Practice Address - Phone:918-502-9555
Practice Address - Fax:918-502-9559
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000742231H00000X
NE301231H00000X
IA001036237600000X
NE121237700000X
OK4696231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025839400Medicaid
IA1972899730Medicaid
IA058970020Medicare PIN