Most Relevant Information
Provider Data
| NPI Number: | 1003334475 |
| Provider Name: | TARA C STARK RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | R159399 |
Most Important Dates
| Enumeration Date: | 09/06/2017 |
| Last Updated: | 09/06/2017 |
Provider Practice Location
10440 LITTLE PATUXENT PKWY STE 800
COLUMBIA
MD
210443569
Practice Location Phone/Fax
| Phone: | 4109106714 |
| Fax: |
Provider Mailing Location
10440 LITTLE PATUXENT PKWY STE 800
COLUMBIA
MD
210443569
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |