Stark, Jacqueline A

Stark, Jacqueline A is an individual health care provider with primary practice located at 12500 Aurora Dr , Pleasant Prairie WI 53158-1227. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Stark, Jacqueline A can be contacted via phone (262) 857-5000.

Contact Information

Primary practice address
12500 Aurora Dr Pleasant Prairie WI 53158-1227
Phone: (262) 857-5000
Fax: (262) 857-5001
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 1999139490 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 6437 Wisconsin

Profile Details

NPI number 1811052319
LBN Legal business name Stark, Jacqueline A
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 26th, 2006
Last updated Nov 24th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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