Stacey Stark, FNP
NPI 1104704477 · Family Nurse Practitioner · Poplar Bluff, MO
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Stacey Stark, FNP is a Family Nurse Practitioner provider in Poplar Bluff, MO (NPI 1104704477).
Provider details
- NPI number
- 1104704477
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- No
- License
- 2025038960 (MO)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-08-25
- Last updated
- 2025-09-15
- Certified
- 2025-09-15
Frequently asked questions
- What is Stacey Stark's NPI number?
- Stacey Stark's National Provider Identifier (NPI) is 1104704477, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Stacey Stark's specialty?
- Stacey Stark is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Stacey Stark located?
- Stacey Stark's practice location on file with NPPES is 2340 Katy Ln, Poplar Bluff, MO 63901-2300.
- What is Stacey Stark's phone number?
- The practice phone number listed in the NPPES registry for Stacey Stark is (573) 290-3293.
- Does Stacey Stark accept Medicare?
- Stacey Stark is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Stacey Stark's NPI active?
- Yes — Stacey Stark's NPI (1104704477) is active in the NPPES registry as of the last update on 2025-09-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.