Individual provider · Type 1 NPI

Leita N. Stark, FNP-BC

Family Nurse Practitioner · Mantachie, MS

NPI number 1760719447 Active

Practice location

5500 Highway 363
Mantachie, MS 38855-7197

Call (662) 282-4226 Map

Mailing address

95 Ivie Ln
Mantachie, MS 38855-8383

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XR862379 (MS)

Family Nurse Practitioner: Definition to come...

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About NPI 1760719447

Leita N. Stark, FNP-BC's National Provider Identifier is 1760719447, issued on Nov 17, 2009. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Mantachie, MS. The record was last updated on Nov 17, 2009.