Individual
NOLA FAY STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
(208) 422-1188
Mailing address
4024 IVY DR, NAMPA, ID 83686-8852
(208) 466-5490
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP56
ID
Other
Enumeration date
08/28/2006
Last updated
07/08/2007
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