Provider Demographics
NPI:1639516586
Name:STARKMAN, MARCIA SUSAN (APRN, MSN, PMHCNS-BC)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:SUSAN
Last Name:STARKMAN
Suffix:
Gender:F
Credentials:APRN, MSN, PMHCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 N HIATUS RD UNIT 450958
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33345-8450
Mailing Address - Country:US
Mailing Address - Phone:954-440-5141
Mailing Address - Fax:954-908-6466
Practice Address - Street 1:2035 E HAZZARD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-1307
Practice Address - Country:US
Practice Address - Phone:954-440-5141
Practice Address - Fax:954-906-6466
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-02
Last Update Date:2021-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9301357163WP0807X, 163WP0808X
PACNS000309364SP0807X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent