Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 209.008374 | IL |
NPI | 1043510597 |
---|---|
Provider Name | Kimberly Ellen Starr |
First Address | Naperville, IL 60564-5041 |
Second Address | Naperville, IL 60564-5041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2010 |
Last Update Date | 01/08/2016 |