Individual provider · Type 1 NPI
Michael Stark
Licensed Vocational Nurse · Pleasant Prairie, WI
Practice location
12049 44th Ave
Pleasant Prairie, WI 53158-3927
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 719020 (CA) |
| Licensed Vocational Nurse Primary | 164X00000X | 043133707 (IL) |
Licensed Vocational Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. [An alternate term for licensed practical nurse arising from difference in occupational titles between states and post-high school training programs and institutions.] Requirements for education, experience, licensure, and job re…
About NPI 1194617647
Michael Stark's National Provider Identifier is 1194617647, issued on Jul 18, 2025. The primary taxonomy on file is Licensed Vocational Nurse (164X00000X), and the practice location is in Pleasant Prairie, WI. The record was last updated on Jul 18, 2025.