Provider Demographics
NPI:1053400747
Name:BARTLETT-RONE, STARRLA R (PA)
Entity type:Individual
Prefix:
First Name:STARRLA
Middle Name:R
Last Name:BARTLETT-RONE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 51888
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82605-1888
Mailing Address - Country:US
Mailing Address - Phone:307-995-8100
Mailing Address - Fax:307-995-8137
Practice Address - Street 1:6550 E 2ND ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4321
Practice Address - Country:US
Practice Address - Phone:307-995-8100
Practice Address - Fax:307-995-8137
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY401363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q74764Medicare UPIN