person
Jody A. Stark, NP
Family Nurse Practitioner in Ontario, Oregon
NPI 1851472989

Jody A. Stark is a Family Nurse Practitioner based in Ontario, OR and is specialized in Family. Jody A. Stark practices in Ontario, OR and has the professional credentials of NP. The NPI Number for Jody A. Stark is 1851472989 and holds a License No. 200550081NP (Oregon).

The current practice location address for Jody A. Stark is 932 W Idaho Ave, Ontario, OR and can be reached out via phone at 541-889-2244 and via fax at 541-889-2626.

Location: 932 W Idaho Ave, Ontario, OR, 97914-0020
person
Provider Profile Details
NPI Number
1851472989
Provider Name
Jody A. Stark
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
932 W Idaho Ave, Ontario, OR, 97914-0020
Phone Number
541-889-2244
Fax Number
541-889-2626
Provider Enumeration Date
10/17/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500656154 05 OR
500614019 05 OR
institution
Provider Business Practice Location Address Details
Address
932 W Idaho Ave
City
State
Zip
97914-2155
Phone Number
541-889-2244
Fax Number
541-889-2626
person
Provider Business Mailing Address Details
Address
932 W Idaho Ave
City
State
Zip
97914-2155
Phone Number
541-889-2244
Fax Number
541-889-2626
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
079043254N1 (Oregon)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
200550081NP (Oregon)
Definition
Definition to come...
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