Individual
KIMBERLY M STARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-3911
Mailing address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-3911
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2000173014
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265670335
—
MO
05
—
176119758
—
AR
05
—
425509908
—
MO
01
—
431560263
TRICARE WEST
—
01
—
P00689760
RAILROAD MEDICARE
—
Enumeration date
01/28/2009
Last updated
02/15/2023
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