Individual
DANA STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2731 HEALTHCARE DR, SYRACUSE, NE 68446-7880
(402) 269-2611
Mailing address
PO BOX N, SYRACUSE, NE 68446-0518
(402) 269-2611
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0673
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6830390
—
SD
Enumeration date
04/09/2008
Last updated
09/02/2022
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