Erin Anne Stark (NPI# 1609349315, PAC ID# 0648511931) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL.
| Nation Provider ID (NPI) | 1609349315 |
| PAC ID by PECOS | 0648511931 |
| Professional Enrollment ID | I20190415002434 |
| Full Name | Erin Anne Stark |
| Organization Legal Name | NOTTAWASEPPI HURON BAND OF THE POTAWATOMI |
| Address |
1474 Mno Bmadzewen Way Fulton MI 49052-9623 |
| Phone Number | 2697294422 |
| Gender | F |
| Graduation Year | 2016 |
| Primary Specialty | REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL |
| Group Practice PAC ID | 2769441286 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1474 Mno Bmadzewen Way, Fulton, MI 49052-9623 | 2697294422 | NOTTAWASEPPI HURON BAND OF THE POTAWATOMI |
| 311 State St Se, Grand Rapids, MI 49503-4312 | 6162490159 | NOTTAWASEPPI HURON BAND OF THE POTAWATOMI |
| Organization Legal Name | NOTTAWASEPPI HURON BAND OF THE POTAWATOMI |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tadd A Heft | Internal Medicine | Nottawaseppi Huron Band of The Potawatomi | 311 State St Se, Grand Rapids, MI 49503-4312 |
| Jolane S Conklin | Nurse Practitioner | Nottawaseppi Huron Band of The Potawatomi | 1474 Mno Bmadzewen Way, Fulton, MI 49052-9623 |
| Hope M Howard | Physician Assistant | Nottawaseppi Huron Band of The Potawatomi | 1474 Mno Bmadzewen Way, Fulton, MI 49052-9623 |
| Matthew B Woods Iv | Family Practice | Nottawaseppi Huron Band of The Potawatomi | 1474 Mno Bmadzewen Way, Fulton, MI 49052-9623 |
| Street Address |
1474 MNO BMADZEWEN WAY |
| City | FULTON |
| State | MI |
| Zip | 49052-9623 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jolane S Conklin | Nurse Practitioner | Nottawaseppi Huron Band of The Potawatomi | 1474 Mno Bmadzewen Way, Fulton, MI 49052-9623 |
| Hope M Howard | Physician Assistant | Nottawaseppi Huron Band of The Potawatomi | 1474 Mno Bmadzewen Way, Fulton, MI 49052-9623 |
| Matthew B Woods Iv | Family Practice | Nottawaseppi Huron Band of The Potawatomi | 1474 Mno Bmadzewen Way, Fulton, MI 49052-9623 |
| City | FULTON |
| Zip Code | 49052 |
| Specialty | REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL |
| City + Specialty | FULTON + REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL |
Please comment or provide details below to improve the information on Erin Anne Stark.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.