MS. SALLY MAGDALEN STARK (NPI# 1528040995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528040995 |
| Entity Type | Individual |
| Full Name | MS. SALLY MAGDALEN STARK |
| Credential | NP |
| Practice Address |
110 W Ent Ave Peterson Afb CO 80914-1595 |
| Mailing Address |
110 W Ent Avenue Peterson Afb CO 80914-1595 |
| Practice Telephone | 7195560510 |
| Practice Fax Number | 8668677926 |
| Mailing Telephone | 7195560510 |
| Mailing Fax Number | 8668677926 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2012-03-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
57995 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
110 W ENT AVE |
| City | PETERSON AFB |
| State | CO |
| Zip Code | 80914-1595 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194250399 | Megan Nicole Morley | Registered Nurse | 110 W Ent Ave, Peterson Afb, CO 80914-1595 | 2017-04-25 |
| 1932514171 | 21st Medical Group | Pharmacy | 110 W Ent Ave, Peterson Afb, CO 80914-1595 | 2014-06-26 |
| 1437309952 | Maureen Forsythe Kimsey | Psychologist | 110 W Ent Ave, Peterson Afb, CO 80914-1595 | 2008-09-19 |
| 1649448275 | Monique Mcwilliams Wall | Social Worker | 110 W Ent Ave, Attn: 21 Mdos/sgoh-mental Health, Peterson Afb, CO 80914-1595 | 2008-02-17 |
| 1972575645 | John Franklin Watkins IIi | Dentist | 110 W Ent Ave, Attn 2, 21ds/sggd, Peterson Afb, CO 80914-1540 | 2006-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356897250 | Kym Littlefield Whitaker | Nurse Practitioner | 110 Ent Avenue, Peterson Afb, CA 80914 | 2016-08-30 |
| 1114322583 | Jessica Charmaine Johnson | Social Worker | 559 Vincent St, Bldg 959, Attn: 21 Omrs/sgow, Peterson Afb, CO 80914 | 2014-10-28 |
| 1306916267 | John Frank Drozd | Psychologist | 21st Medical Group, 559 Vincent Street, Peterson Afb, CO 80914 | 2006-11-08 |
| 1801858865 | Moshe Mark Douglas Wexler | Clinical Neuropsychologist | 110 W. Ent Ave. Bldg 725, 21 Mdos/sgoh, Pafb, CO 80914 | 2006-04-05 |
| 1215902002 | William J Dickson | Dentist | Peterson Afb, Bld 950, Colorado Springs, CO 80914 | 2006-02-23 |
| 1740889773 | Brandon Dean Estes | Dental Hygienist | 1055 Stewart Ave, Bldg 2018, Apo, AA 80914 | 2020-10-21 |
| 1811378607 | Justin Henry Noble | Family Medicine | 559 Vincent St, Colorado Springs, CO 80914 | 2015-06-17 |
| 1225458789 | Brianna Mcmurray | Family Medicine | 559 Vincent St Bldg 959, Colorado Springs, CO 80914 | 2014-04-23 |
| 1720406796 | Beth D Achterhoff | Physical Therapist | 559 Vincent St Bldg 959, Peterson Afb, CO 80914 | 2014-04-07 |
| 1225310162 | Zachary Edward Bishop | Pharmacist | 559 Vincent St, Attn: 21 Mdss/sgsap, Peterson Afb, CO 80914 | 2011-09-16 |
| Find all providers in zip 80914 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871021444 | Danielle Markeeta Sales | Nurse Practitioner | 559 Vincent St Bldg 959, Peterson Afb, CO 80914-1541 | 2017-05-26 |
| 1376516989 | Debra Lynn Arabia | Nurse Practitioner | 559 Vincent St, Attn: 21 Mdos/sgomg-women's Health, Peterson Afb, CO 80914-1540 | 2006-02-13 |
| 1043290323 | Michelle Montgomery | Nurse Practitioner | 559 Vincent St, Family Practice Clinic, Peterson Afb, CO 80914-1540 | 2006-01-20 |
| 1932190998 | Madeline Diane Howell | Nurse Practitioner | 559 Vincent St, Suite 605, Peterson Afb, CO 80914-1540 | 2005-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634522 | Irene Jaw | Nurse Practitioner | 16087 E Geddes Ln, Aurora, CO 80016-1496 | 2020-09-21 |
| 1124634795 | Carolyn Findlay | Nurse Practitioner | 1126 Quince St, Denver, CO 80220-3107 | 2020-09-19 |
| 1477177533 | Obstetrix Medical Group of Colorado, P.C. | Nurse Practitioner | 90 Health Park Dr Ste 390, Louisville, CO 80027-9742 | 2020-06-04 |
| 1770128092 | Mckenna Bagan | Nurse Practitioner | 4600 Hale Pkwy Ste 400, Denver, CO 80220-4000 | 2019-11-11 |
| 1548810880 | Briana Renae Bell | Nurse Practitioner | 111 11st Unit 102, 772865, Steamboat Springs, CO 80477-2865 | 2019-09-18 |
| 1649823170 | Chelsea Mynyk | Nurse Practitioner | 1951 Charbray Pt, Castle Rock, CO 80108-8439 | 2019-07-23 |
| 1124585914 | Erin Foust | Nurse Practitioner | 12053 Spotted Pony Cir, Fort Collins, CO 80524-8797 | 2019-02-27 |
| 1720544729 | Felicia Diane Milam | Nurse Practitioner | 2226 S Fraser St Unit 3, Aurora, CO 80014-4534 | 2019-02-14 |
| 1518462803 | Erin Sunday, Whnp, LLC | Nurse Practitioner | 518 Sopris Ave, Crested Butte, CO 81224-8122 | 2018-03-28 |
| 1508361320 | Darlene Abramajtis | Nurse Practitioner | 175 W Cheyenne Rd Apt 410, Colorado Springs, CO 80906-2555 | 2018-03-25 |
| Find all providers with the same taxonomy | ||||
| City | PETERSON AFB |
| Zip Code | 80914 |
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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.