Individual
MRS. CHARLOTTE JANE STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2800 FAYETTEVILLE RD, VAN BUREN, AR 72956-6523
(479) 314-4000
(479) 314-4050
Mailing address
2800 FAYETTEVILLE RD, VAN BUREN, AR 72956-6523
(479) 314-4000
(479) 314-4050
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
80977
CO
363LF0000X
Family Nurse Practitioner
Primary
219426
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500027209
RAILROAD MEDICARE
—
01
—
84-1090521008
ROCKY MTN HEALTH PLANS
—
Enumeration date
07/08/2005
Last updated
07/13/2023
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