Individual
AMY MARIE STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 E 104TH ST, KANSAS CITY, MO 64131
(816) 769-5109
Mailing address
901 E 104TH ST, KANSAS CITY, MO 64131-4517
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
2005008569
MO
363LF0000X
Family Nurse Practitioner
Primary
2017020422
MO
Other
Enumeration date
05/25/2017
Last updated
12/22/2019
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