NPI 1194617647

Michael Stark

Practitioner Licensed Vocational Nurse Pleasant Prairie, WI

Practice location

Address: 12049 44th Ave, Pleasant Prairie, WI 53158-3927
Phone: (530) 562-5476

Registered specialties (2)

Licensed Vocational Nurse Primary

Nursing Service Providers Taxonomy 164X00000X Licence 043133707 (IL)

Other Licensed Vocational Nurse providers in Wisconsin →

Licensed Vocational Nurse

Nursing Service Providers Taxonomy 164X00000X Licence 719020 (CA)

Registry record

NPI: 1194617647
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Jul 2025
Record last updated: 18 Jul 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.