Individual
JENESSA PAYANO STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, CPM
Contact information
Practice address
167 MAIN ST, TUBA CITY, AZ 86045
(866) 976-5941
Mailing address
167 MAIN ST, TUBA CITY, AZ 86045
(866) 976-5941
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
1036
MN
367A00000X
Advanced Practice Midwife
Primary
—
MN
Other
Enumeration date
11/18/2013
Last updated
08/30/2019
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