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NPI Code Detail

MEDICARE: MRS. JENNIFER MARIE STARK AC-PNP

MEDICARE: MRS. JENNIFER MARIE STARK AC-PNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse PractitionerAP139716TX

General Provider Information

NPI Number : 1437701471
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER MARIE STARK AC-PNP
Provider Business Mailing Address
First Line : PO BOX 840003
Second Line :
City : DALLAS
State : TX
Zip : 75284-0003
Country : US
Telephone Number : 855-691-9890
Fax Number : 781-276-6487
Provider Business Practice Location Address
First Line : 1901 SW H K DODGEN LOOP
Second Line :
City : TEMPLE
State : TX
Zip : 76502-1814
Country : US
Telephone Number : 254-724-5437
Fax Number : 254-935-4111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2019
Last Update Date : 01/22/2026

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