MARY KATHRYN STARK (NPI# 1871629055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871629055 |
| Entity Type | Individual |
| Full Name | MARY KATHRYN STARK |
| Other Name | MARY KATHRYN DERIEG |
| Credential | RN, MS, FNP, DNP |
| Practice Address |
3668 N Harbor Ln Boise ID 83703-6914 |
| Mailing Address |
2001 E Madison St Seattle WA 98122-2959 |
| Practice Telephone | 8007690045 |
| Mailing Telephone | 2064300316 |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
200750019NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10056 Se 240th St Ste A, Kent, WA 980315126 | 8007690045 | |
| 10210 State Ave, Marysville, WA 982717214 | 8007690045 | |
| 1105 S 348th St, Federal Way, WA 980037027 | 8007690045 | |
| 1229 Madison St Ste 1040, Seattle, WA 981043306 | 8007690045 | |
| 14730 Ne 8th St, Bellevue, WA 980074116 | 8007690045 | |
| 1509 32nd St, Everett, WA 982014302 | 8007690045 | |
| 1515 Martin Luther King Jr Way, Tacoma, WA 984053933 | 8007690045 | |
| 19505 76th Ave W Ste 200, Lynnwood, WA 980365045 | 8007690045 | |
| 200 2nd Ave N, Twin Falls, ID 833016158 | 8007690045 | |
| 2001 E Madison St, Seattle, WA 981222959 | 8007690045 | |
| 2111 N Northgate Way Ste 218, Seattle, WA 981339012 | 8007690045 | |
| 2112 E Franklin Rd, Meridian, ID 836429024 | 8007690045 | |
| 402 Legion Way Se, Olympia, WA 985011494 | 8007690045 | |
| 426 E 8th St, Port Angeles, WA 983626220 | 8007690045 | |
| 5020 Roosevelt Way Ne Ste 1, Seattle, WA 981053644 | 8007690045 | |
| 702 30th Ave Sw, Puyallup, WA 983732756 | 8007690045 | |
| 723 Ne Riddell Rd, Bremerton, WA 983103030 | 8007690045 | |
| 932 W Idaho Ave, Suite 100, Ontario, OR 979142155 | 5418892244 | 5418892626 |
| 9942 8th Ave Sw, Seattle, WA 981063036 | 8007690045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588891295 | Mary Stark | Registered Nurse | 67 Heritage Ln, Riverhead, NY 11901-5702 | 2009-06-20 |
| 1255413944 | Mary E Stark | Registered Nurse | 30 Harriman Drive, Goshen, NY 10924 | 2006-10-20 |
| 1710916143 | Mary Kathleen Stark | Specialist/Technologist | 7559 Sherlock Dr, Onsted, MI 49265-9416 | 2006-06-30 |
| 1851352884 | Mary Jean Stark | Physician Assistant | 755 Norman Dr, Lebanon, PA 17042-7497 | 2006-03-29 |
| Street Address |
3668 N HARBOR LN |
| City | BOISE |
| State | ID |
| Zip Code | 83703-6914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376011619 | Ali Renee Klippenstein | Nurse Practitioner | 3668 N Harbor Ln, Boise, ID 83703-6914 | 2018-11-05 |
| 1285938985 | Brenna Lynn Jensen | Physician Assistant | 3668 N Harbor Ln, Boise, ID 83703-6914 | 2011-01-10 |
| 1164734240 | Christie Jeanne Beattie | Nurse Practitioner | 3668 N Harbor Ln, Boise, ID 83703-6914 | 2010-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386203974 | Dylan Roy | Chiropractor | 5632 W State Street, Boise, ID 83703 | 2019-06-07 |
| 1124476858 | Tidwell Social Work Services and Consulting, Inc. | Community/Behavioral Health | 5999 W. State St., Boise, ID 83703 | 2016-06-03 |
| 1801251244 | Rebecca Lynn Cushing | Massage Therapist | 5909 W. State St, Boise, ID 83703 | 2015-12-30 |
| 1790181675 | Malinda Poe | Counselor | 4440 W Taft St, Boise, ID 83703 | 2014-11-05 |
| 1689079469 | Ashley Harker | Massage Therapist | 5909 W. State St., Boise, ID 83703 | 2014-10-23 |
| 1770987844 | Brick House Recovery | Counselor | 3663 N Lakeharbor Ln, Boise, ID 83703 | 2014-10-17 |
| 1033512538 | Ryan Warburton | Physical Therapist | 2999 N Lakeshore Lane, Ste 120, Boise, ID 83703 | 2014-09-29 |
| 1710386008 | Suzanne Iannaccone | Social Worker | 4090 W State St Ste 221, Boise, ID 83703 | 2014-08-22 |
| 1588092464 | Becky L. Marks | Social Worker | 3858 N. Garden Center Way, Suite 204, Boise, ID 83703 | 2013-10-31 |
| 1700219169 | Pohley Richey | Dietitian, Registered | 6052 W State Street, Boise, ID 83703 | 2013-08-20 |
| Find all providers in zip 83703 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568061398 | Nicolette A Eberline | Nurse Practitioner | 4228 W Guard St Bldg 665, Boise, ID 83705-8049 | 2020-10-22 |
| 1013522275 | Beau Lee | Nurse Practitioner | 2900 N Burton St, Boise, ID 83704-5314 | 2020-09-14 |
| 1588277529 | Tauna Marie Young | Nurse Practitioner | 1681 S Kimball Way, Boise, ID 83709-1654 | 2020-08-28 |
| 1497367114 | Lindsay Ruggles | Nurse Practitioner | 1105 S Federal Way, Boise, ID 83705-2546 | 2020-08-24 |
| 1265056014 | Brynn Crisp | Nurse Practitioner | 1075 N Curtis Rd Ste 100, Boise, ID 83706-1348 | 2020-06-07 |
| 1518592674 | Amber Lynn Gillette | Nurse Practitioner | 1111 S Orchard St Ste 251, Boise, ID 83705-1964 | 2020-03-10 |
| 1265062806 | Jamie Watts | Nurse Practitioner | 5353 W Hill Rd, Boise, ID 83703-2943 | 2020-01-23 |
| 1730654435 | Melissa Gaffrey | Nurse Practitioner | 500 S 8th St, Boise, ID 83702-7107 | 2018-10-09 |
| 1659876399 | Dixie Jean Skinner | Nurse Practitioner | 10583 W. Lake Hazel Rd., Boise, ID 83709-8370 | 2018-03-26 |
| 1063912202 | Devon Moser | Nurse Practitioner | 901 N Curtis Rd Ste 100, Boise, ID 83706-1339 | 2018-02-14 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.