Provider Demographics
NPI:1669696464
Name:STARKE, BARBARA A (RN, MSN, FNP)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:A
Last Name:STARKE
Suffix:
Gender:F
Credentials:RN, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 E FRONT STREET
Mailing Address - Street 2:
Mailing Address - City:BUCHANAN
Mailing Address - State:MI
Mailing Address - Zip Code:49107
Mailing Address - Country:US
Mailing Address - Phone:269-695-3897
Mailing Address - Fax:269-695-0460
Practice Address - Street 1:804 E FRONT STREET
Practice Address - Street 2:
Practice Address - City:BUCHANAN
Practice Address - State:MI
Practice Address - Zip Code:49107
Practice Address - Country:US
Practice Address - Phone:269-695-3897
Practice Address - Fax:269-695-0460
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704120389163WG0000X
MIL1722527363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice