Individual
ANDREA STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
227 N MARKET ST, PAXTON, IL 60957-1123
(217) 379-4864
(217) 379-2604
Mailing address
1120 N MELVIN ST, GIBSON CITY, IL 60936-1477
(217) 784-4251
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209028190
IL
Other
Enumeration date
08/30/2023
Last updated
02/14/2024
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