Provider Demographics
NPI:1730507526
Name:HARVILL, STARR
Entity type:Individual
Prefix:
First Name:STARR
Middle Name:
Last Name:HARVILL
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 1:500 SPILLERS WAY
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-0513
Mailing Address - Country:US
Mailing Address - Phone:478-953-4844
Mailing Address - Fax:478-953-4824
Practice Address - Street 1:500 SPILLERS WAY
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-0513
Practice Address - Country:US
Practice Address - Phone:478-953-4844
Practice Address - Fax:478-953-4824
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012136363L00000X
GARN160142363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner