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Ms. Jacqueline A Stark, CPNP
Nurse Practitioner in Pleasant Prairie, Wisconsin
NPI 1811052319

Jacqueline A Stark is a Nurse Practitioner based in Chicago, WI. Jacqueline A Stark practices in Pleasant Prairie, WI and has the professional credentials of CPNP. The NPI Number for Jacqueline A Stark is 1811052319 and holds a License No. 6437 (Wisconsin).

The current practice location address for Jacqueline A Stark is 12500 Aurora Dr, Pleasant Prairie, WI and can be reached out via phone at 262-857-5000 and via fax at 262-857-5001.

Location: 12500 Aurora Dr, Pleasant Prairie, WI, 60673-5044
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811052319
Provider Name
Jacqueline A Stark
Credential
CPNP
Provider Entity Type
Individual
Gender
Female
Address
12500 Aurora Dr, Pleasant Prairie, WI, 60673-5044
Phone Number
262-857-5000
Fax Number
262-857-5001
Provider Enumeration Date
12/26/2006
Last Update Date
09/14/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100046653 05 WI
institution
Provider Business Practice Location Address Details
Address
12500 Aurora Dr
City
Pleasant Prairie
State
Wisconsin
Zip
53158-1227
Phone Number
262-857-5000
Fax Number
262-857-5001
person
Provider Business Mailing Address Details
Address
12500 Aurora Dr
City
Pleasant Prairie
State
Wisconsin
Zip
53158-1227
Phone Number
262-857-5000
Fax Number
262-857-5001
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
6437 (Wisconsin)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
363LP0200X
License No.
1999139490 (Missouri)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
6437 (Wisconsin)
Definition
Definition to come...
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