Provider Demographics
NPI:1841291531
Name:STARNS, MARCIA (PAC)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:
Last Name:STARNS
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10151 MONTGOMERY BLVD NE BLDG 1
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3670
Mailing Address - Country:US
Mailing Address - Phone:505-855-5503
Mailing Address - Fax:505-855-5533
Practice Address - Street 1:10151 MONTGOMERY BLVD NE BLDG 1
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3670
Practice Address - Country:US
Practice Address - Phone:505-855-5503
Practice Address - Fax:505-855-5533
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPA20150067363A00000X
TNPA 1808363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR115184001Medicaid
Q23460Medicare UPIN
AR5134SP098Medicare ID - Type Unspecified