Stephan Stark, Christina L

Stephan Stark, Christina L is an individual health care provider with primary practice located at 1 Childrens Pl Div Surg Urology Ped, Ste 2A, Saint Louis MO 63110-1002. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Stephan Stark, Christina L can be contacted via phone (314) 454-6034.

Contact Information

Primary practice address
1 Childrens Pl Div Surg Urology Ped, Ste 2A Saint Louis MO 63110-1002
Phone: (314) 454-6034
Fax: (314) 454-2876
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 128777 Missouri

Profile Details

NPI number 1285652099
LBN Legal business name Stephan Stark, Christina L
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Apr 17th, 2025 - about last year

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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Identifiers

StateTypeNumberIssuer
All States NPI 1285652099 NPPES
Missouri MEDICAID 429036403

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