Individual
MRS. SHANA S STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
500 5TH ST, BROOKINGS, OR 97415-9702
(541) 412-2000
(541) 412-2081
Mailing address
PO BOX 67250, LINCOLN, NE 68506-7250
(402) 328-8833
(888) 965-0959
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
201501818NP-PP
OR
363LP2300X
Primary Care Nurse Practitioner
Primary
111628
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487696985
CURRY HEALTH DISTRICT NPI
OR
05
—
500684342
—
OR
01
—
930937095
CURRY HEALTH DISTRICT TAX ID
OR
Enumeration date
02/20/2014
Last updated
09/16/2022
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