Doctor Name: | MRS. MELISSA ANN STARICKA |
NPI Number: | 1134270713 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | N.P. |
License Number: | NP12898 |
Business Practice Address: | 370 Summit Blvd Big Bear Lake, CA - 92315 |
Business Phone Number: | 9098788246 |
Business Fax Number: | |
Mailing Address: | Po Box 6602, BIG BEAR LAKE |
State: | CA |
Postal Code: | 923156602 |
Phone Number: | 9095854016 |
Fax Number: | |
NPI Enumeration Date: | 01/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | NP12898 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |