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Provider Information for 1780955930

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

STARICA SHANELL DAVIS LPN

Other Name:   STARICA GREEN
Gender: FEMALE

Individual NPI: 1780955930

Calendar   Last Updated:  2012-01-19
  Certification Date: 

Details

Name Value
NPI 1780955930
Enumeration Date 2012-01-19
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 25 CROSS GATES RD
GATES, NY 14606-3306
United States

Phone: 585-285-9673 | Fax:
View Map External Link
Primary Practice Address 25 CROSS GATES RD
GATES, NY 14606-3306
United States

Phone: 585-285-9673 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 164W00000X - Licensed Practical Nurse NY 2874801