Healthcare Provider Details
I. General information
NPI: 1487124392
Provider Name (Legal Business Name): ALLISON R STARK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/04/2018
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2300 S 16TH ST
LINCOLN NE
68502-3704
US
IV. Provider business mailing address
PO BOX 860876
MINNEAPOLIS MN
55486-0876
US
V. Phone/Fax
- Phone: 402-475-1011
- Fax: 402-481-4783
- Phone: 402-483-8590
- Fax: 402-483-8599
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 74308 |
| License Number State | NE |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 112700 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: