Provider Demographics
NPI:1700605367
Name:ADAMS, STARLA JEAN
Entity type:Individual
Prefix:
First Name:STARLA
Middle Name:JEAN
Last Name:ADAMS
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 1:1424 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:WELLSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43968-1200
Mailing Address - Country:US
Mailing Address - Phone:234-736-1128
Mailing Address - Fax:
Practice Address - Street 1:1424 CENTER ST
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43968-1200
Practice Address - Country:US
Practice Address - Phone:234-736-1128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH602443240922376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide