Provider Demographics
NPI:1205506698
Name:STARKEY, NELLIE
Entity type:Individual
Prefix:
First Name:NELLIE
Middle Name:
Last Name:STARKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1376 BEAR MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26347-6109
Mailing Address - Country:US
Mailing Address - Phone:304-739-2271
Mailing Address - Fax:
Practice Address - Street 1:1376 BEAR MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:WV
Practice Address - Zip Code:26347-6109
Practice Address - Country:US
Practice Address - Phone:304-739-2271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker