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NPI Code Detail

MEDICARE: MRS. JENNY LEE STARK APRN

MEDICARE:  MRS. JENNY LEE STARK  APRN
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
1363LF0000XFamily Nurse Practitioner11011658FL

General Provider Information

NPI Number : 1225621659
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNY LEE STARK APRN
Provider Business Mailing Address
First Line : 1401 CENTERVILLE RD STE 600
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32308-4661
Country : US
Telephone Number : 317-225-7652
Fax Number :
Provider Business Practice Location Address
First Line : 1401 CENTERVILLE RD STE 600
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32308-4661
Country : US
Telephone Number : 850-878-8121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2021
Last Update Date : 04/11/2024

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Directions to “ MRS. JENNY LEE STARK APRN” Practice Location

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