SHANNON LYNN STARK NP NPI 1730645763

NPI Information

NPI: 1730645763
Provider Name: SHANNON LYNN STARK, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: SUMMIT MEDICAL GROUP ARIZONA LLC

PECOS Registration: Yes

Address:
2735 E MAIN ST STE 2&3
MESA, AZ
ZIP 85213
Phone: (480) 867-1722
Get Directions

Shannon Lynn Stark, NP is a family nurse practitioner in Mesa, AZ with 6 years of experience. Shannon Lynn Stark, NP NPI is 1730645763. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2735 E MAIN ST STE 2&3
MESA, AZ
ZIP 85213-269
Phone: (480) 867-1722
Fax: (480) 867-1709

The NPI 1730645763 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/14/2019 and was last updated on 3/9/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	222543	ARIZONA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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