Basic Information
| Provider Information | |||||||||
| NPI: | 1831363894 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STARR | ||||||||
| FirstName: | SANDRA | ||||||||
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| Credential: | APN, BC-FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 238 SUMMAR DR | ||||||||
| Address2: | |||||||||
| City: | JACKSON | ||||||||
| State: | TN | ||||||||
| PostalCode: | 383013906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7319277628 | ||||||||
| FaxNumber: | 7319277642 | ||||||||
| Practice Location | |||||||||
| Address1: | 4039 HIGHLAND ST | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | MILAN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 383583483 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7317231327 | ||||||||
| FaxNumber: | 7317231339 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2008 | ||||||||
| LastUpdateDate: | 10/12/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APN0000011752 | TN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LP0808X | APN0000011752 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.