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Individual

CHRISTAL R STARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, MSN, C-PNP

Contact information

Practice address
400 FAIRVIEW HEIGHTS RD, SUITE 302, SUMMERSVILLE, WV 26651-9308
(304) 872-7063
(304) 872-7080
Mailing address
400 FAIRVIEW HEIGHTS RD, SUITE 302, SUMMERSVILLE, WV 26651-9308
(304) 872-7063
(304) 872-7080

Taxonomy

Speciality
Code
Description
License number
State
364SP0200X
Pediatric Clinical Nurse Specialist
Primary
67293
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
67293
STATE LICENSE
WV
Enumeration date
12/12/2007
Last updated
08/12/2014
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