Nikki Stark
Individual provider Active NPI Case Manager/Care Coordinator · Rose Bud, AR
NPI 1053662346 · NPPES record last updated Sep 26, 2012
Key facts
- NPI
- 1053662346
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 931 Highway 5
Rose Bud, AR 72137-9721 - Phone
- (501) 556-4210
- NPI assigned
- Sep 26, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
931 Highway 5
Rose Bud, AR 72137-9721
Mailing address
1204 N Fir St
Beebe, AR 72012-2712
Other providers in Rose Bud, AR
All providers in Rose Bud, AR · Case Manager/Care Coordinator in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.