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Individual

KACEY L STARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2000 NEUSE BLVD, NEW BERN, NC 28560-3449
(252) 633-8111
Mailing address
4535 DRESSLER RD NW, CANTON, OH 44718-2545
(800) 828-0898

Taxonomy

Speciality
Code
Description
License number
State
163WF0300X
Flight Registered Nurse
194691
NC
363LF0000X
Family Nurse Practitioner
Primary
5023171
NC

Other

Enumeration date
01/06/2025
Last updated
11/04/2025
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