Provider Information for 1699065524
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
Dr. HEIDI GABRIELA STARK-BANK Ph.D.
Other Names:Former Name:Dr. HEIDI GABRIELA STARK Ph.D.Sex: Female
NPI: 1699065524
Last Updated: 2022-07-14
Certification Date: 2022-07-14
Certification Date: 2022-07-14
Details
| Name | Value | ||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1699065524 | ||||||||||||||||||||||||||||||||||||
| Enumeration Date | 2011-04-12 | ||||||||||||||||||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||||||||||||||||||||||
| Status | Active | ||||||||||||||||||||||||||||||||||||
| Mailing Address | PO BOX 60193 LAS VEGAS, NV 89160-0193 United States Phone: 858-977-1878 | Fax:702-365-0602 | ||||||||||||||||||||||||||||||||||||
| Primary Practice Address | 8880 W SUNSET RD STE 200 LAS VEGAS, NV 89148-5014 United States Phone: 702-805-5360 | Fax: | ||||||||||||||||||||||||||||||||||||
| Secondary Practice Address(es) | 9909 MIRA MESA BLVD STE 250 | ||||||||||||||||||||||||||||||||||||
| Health Information Exchange |
| ||||||||||||||||||||||||||||||||||||
| Other Identifiers |
| ||||||||||||||||||||||||||||||||||||
| Taxonomy |
|