| Andrea Stark, APRN | |
|
227 N Market St, Paxton, IL 60957-1123 | |
| (217) 379-4864 | |
| (217) 379-2604 |
| Full Name | Andrea Stark |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 227 N Market St, Paxton, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568247229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 209028190 (Illinois) | Primary |
| Entity Name | Gibson Community Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114935681 PECOS PAC ID: 5092703124 Enrollment ID: O20040505001293 |
| Mailing Address | Practice Location Address |
|---|---|
| Andrea Stark, APRN 1120 N Melvin St, Gibson City, IL 60936-1477 Ph: (217) 784-4251 | Andrea Stark, APRN 227 N Market St, Paxton, IL 60957-1123 Ph: (217) 379-4864 |
Shelby Warner, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 227 N Market St, Paxton, IL 60957 Phone: 217-379-4864 | |
Celia A Hethke, RNC, ANP, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 227 N Market St, Paxton, IL 60957 Phone: 217-379-4864 | |
Mrs. Kelli Marie Vaughn, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 227 N Market St, Paxton, IL 60957 Phone: 217-379-4864 | |
Justi Marie Hudson, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 227 N Market St, Paxton, IL 60957 Phone: 217-379-4864 Fax: 217-379-2604 |