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NIKKI STARK

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1053662346

Individual Registrant:
 NIKKI  STARK 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
931 HIGHWAY 5  ROSE BUD, AR 72137-9721 US
Tel: 501-556-4210  Fax: --

Contact information for business:
1204 N FIR ST  BEEBE, AR 72012-2712 US
Tel: --  Fax: --

Registration Information:
NPI: 1053662346
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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