Provider Demographics
NPI:1376918912
Name:START, STORMY
Entity type:Individual
Prefix:
First Name:STORMY
Middle Name:
Last Name:START
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 1:2426 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4146
Mailing Address - Country:US
Mailing Address - Phone:907-244-6402
Mailing Address - Fax:
Practice Address - Street 1:2426 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4146
Practice Address - Country:US
Practice Address - Phone:907-244-6402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-08
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK113561163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK104743OtherCERTIFIED DIRECT-ENTRY MIDWIFE