LEITA N STARK

MANTACHIE, MS
NPI1760719447
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MS  R862379)
Enumeration Date2009-11-17
Last Update Date2009-11-17
Business Address
-- LEITA N STARK FNP-BC
5500 HIGHWAY 363
MANTACHIE, MS 38855-7197
Phone number: 662-282-4226
Mailing Address
-- LEITA N STARK FNP-BC
95 IVIE LN
MANTACHIE, MS 38855-8383
Phone number: 662-322-3278
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