Individual provider · Type 1 NPI

Stacey Diane Stark, FNP

Family Nurse Practitioner · Poplar Bluff, MO

NPI number 1104704477 Active

Practice location

2340 Katy Ln
Poplar Bluff, MO 63901-2300

Mailing address

190 Merlin Dr
Poplar Bluff, MO 63901-8374

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X2025038960 (MO)

Family Nurse Practitioner: Definition to come...

8 other providers at this address

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About NPI 1104704477

Stacey Diane Stark, FNP's National Provider Identifier is 1104704477, issued on Aug 25, 2025. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Poplar Bluff, MO. The record was last updated on Sep 15, 2025.