Individual
KIMBERLY JEAN STARK-VAN NOORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
44021 DEQUINDRE, FERNDALE, MI 48085
(248) 964-8787
(248) 964-6133
Mailing address
44021 DEQUINDRE, ATTN JAN MCFARLANE, TROY, MI 48085
(248) 964-8787
(248) 964-6133
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004641
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F31794
BLUE CROSS BLUE SHIELD OF
MI
01
—
383601519
COMMERCIAL INSURANCE
MI
Enumeration date
07/19/2007
Last updated
11/19/2021
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