Individual
VICKIE STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2845 SIENA HEIGHTS DR, HENDERSON, NV 89052-4153
(702) 877-5099
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 877-5306
(702) 252-4906
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
11270
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100505591
—
NV
05
—
1740385913
—
NV
Enumeration date
09/13/2006
Last updated
03/25/2024
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