Individual
SUSAN D STAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4431 W 650 S, WILLIAMSPORT, IN 47993-8273
(217) 497-2527
Mailing address
4431 W 650 S, WILLIAMSPORT, IN 47993-8273
(217) 497-2527
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043040701
IL
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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