Provider Demographics
NPI:1871846584
Name:STARK, SHERRI LINN (PHARM D)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:LINN
Last Name:STARK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:SHERRI
Other - Middle Name:LINN
Other - Last Name:DINGLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:1921 STONECIPHER DR
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-3439
Mailing Address - Country:US
Mailing Address - Phone:580-436-3980
Mailing Address - Fax:580-272-1016
Practice Address - Street 1:1921 STONECIPHER DR
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-3439
Practice Address - Country:US
Practice Address - Phone:580-436-3980
Practice Address - Fax:580-272-1016
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT11401183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist