Provider Demographics
NPI:1629871157
Name:STARKS, CATHERINE L (LPN)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:L
Last Name:STARKS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:L
Other - Last Name:WIGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5500 MING AVE STE 410
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-4631
Mailing Address - Country:US
Mailing Address - Phone:406-668-0463
Mailing Address - Fax:
Practice Address - Street 1:77 TRAILS END RD
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MT
Practice Address - Zip Code:59917-9332
Practice Address - Country:US
Practice Address - Phone:406-727-4374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPN0000089463164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse