Individual
SUSAN ELIZABETH STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5211 HIGHWAY 110, ESSENTIA HEATLH NORTHERN PINES CLINIC, AURORA, MN 55705-1522
(218) 229-3311
Mailing address
5211 HIGHWAY 110, ESSENTIA HEALTH NORTHERN PINES CLINIC, AURORA, MN 55705-1522
(218) 229-3311
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R153102-8
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598105694
—
MN
Enumeration date
07/03/2013
Last updated
10/18/2013
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