Individual
ROBERT O STARK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1925 W MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(303) 776-1234
(720) 494-3107
Mailing address
1925 W MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(303) 776-1234
(720) 494-3107
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
129114
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
129114
LICENSE
CO
Enumeration date
02/03/2006
Last updated
07/08/2007
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