Provider Demographics
NPI:1831700244
Name:STARLING, LATAVIA
Entity type:Individual
Prefix:
First Name:LATAVIA
Middle Name:
Last Name:STARLING
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 1:1903 STATE HIGHWAY 31 E
Mailing Address - Street 2:
Mailing Address - City:KILGORE
Mailing Address - State:TX
Mailing Address - Zip Code:75662-6805
Mailing Address - Country:US
Mailing Address - Phone:903-392-5466
Mailing Address - Fax:
Practice Address - Street 1:1903 STATE HIGHWAY 31 E
Practice Address - Street 2:
Practice Address - City:KILGORE
Practice Address - State:TX
Practice Address - Zip Code:75662-6805
Practice Address - Country:US
Practice Address - Phone:903-392-5466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX344401164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse