Provider Demographics
NPI:1730502477
Name:STAROSKA, JUSTINA LYNN (CNP)
Entity type:Individual
Prefix:MRS
First Name:JUSTINA
Middle Name:LYNN
Last Name:STAROSKA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11315 SPRINGFIELD PIKE
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:OH
Mailing Address - Zip Code:45246-4201
Mailing Address - Country:US
Mailing Address - Phone:513-771-9100
Mailing Address - Fax:513-771-9282
Practice Address - Street 1:11315 SPRINGFIELD PIKE
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:OH
Practice Address - Zip Code:45246-4201
Practice Address - Country:US
Practice Address - Phone:513-771-9100
Practice Address - Fax:513-771-9282
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN09000418A176B00000X
IN71013425A367A00000X
OHNP-15477363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No176B00000XOther Service ProvidersMidwife
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300037844Medicaid