Shannon Gail Stark
Nurse Practitioner - Family Medicine
39 Pearl St W
Sidney
, New York 13838
Shannon Gail Stark
Nurse Practitioner - Family Medicine
39 Pearl St W
Sidney
, New York 13838
(212) 927-9706
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About
Features
Specialties
- Nurse Practitioner - Family Medicine
Languages spoken
- English
Location
First Address
- Shannon Gail Stark
- 205 Crocker Hill Rd
- Binghamton, NY
- Zip : 13904-2513
- Phone : (212) 927-9706
Second Address
- Shannon Gail Stark
- 39 Pearl St W
- Sidney, NY
- Zip : 13838
- Phone : (607) 561-2021
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LF0000X | Nurse Practitioner - Family Medicine | 343815 | NY |
National Provider Identifier
| NPI | 1003129438 |
|---|---|
| Provider Name | Shannon Gail Stark |
| First Address | Binghamton, NY 13904-2513 |
| Second Address | Sidney, NY 13838 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/07/2010 |
| Last Update Date | 04/02/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.