Jerry Randall Stark, RN
NPI #1447507066 in Southaven, Mississippi
Provider Information
- NPI Number
- 1447507066
- Entity Type
- Individual
- Name
- Jerry Randall Stark, RN
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Registered Nurse - Emergency
- Credential
- RN
- Enumeration Date
- Aug 14, 2012
- Last Updated
- Aug 14, 2012
Practice Location
- Address
- 848 VALLEY SPRINGS DR
- City
- Southaven
- State
- Mississippi
- ZIP Code
- 38671-4336
- Phone
- (901) 337-7778
Specialties & Taxonomy Codes
| Specialty |
|---|
| Registered Nurse - Emergency — Emergency |
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