Individual
STACEY DIANE STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2340 KATY LN, POPLAR BLUFF, MO 63901-2300
(573) 290-3293
Mailing address
190 MERLIN DR, POPLAR BLUFF, MO 63901-8374
(573) 718-9831
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2025038960
MO
Other
Enumeration date
08/25/2025
Last updated
09/15/2025
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