Individual
STARR PENROD OLLERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
682 W SCHOOL BUS LN, SNOWFLAKE, AZ 85937-5262
(928) 536-4156
(928) 536-2634
Mailing address
682 W SCHOOL BUS LN, SNOWFLAKE, AZ 85937-5262
(928) 536-4156
(928) 536-2634
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN119093
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PRO1TECT
—
AZ
Enumeration date
08/26/2008
Last updated
08/26/2008
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