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Individual

MRS. KRISTIN NICOLE STARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, CNM, WHNP

Contact information

Practice address
6678 W THUNDERBIRD RD, GLENDALE, AZ 85306-3721
(602) 978-1500
(602) 978-8944
Mailing address
3003 N CENTRAL AVE STE 1600, PHOENIX, AZ 85012-2908
(602) 323-3344
(602) 323-3496

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
218557
AZ
367A00000X
Advanced Practice Midwife
218557
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
098184
AZ
Enumeration date
10/19/2018
Last updated
07/19/2024
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