Doctor profile · Federal record
Dr. Jacqueline Stark, CPNP
Nurse Practitioner · Pediatric Nurse Practitioner · Psychiatric/Mental Health Nurse Practitioner · Pleasant Prairie, WI
- NPI 1811052319
- 20 yrs on file
- Licensed in 2 states
- Female
- Group practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
12500 Aurora Dr
Pleasant Prairie, WI 531581227
(262) 857-5000
fax (262) 857-5001 - Additional location
-
10400 75Th St
Kenosha, WI 531427884
(262) 948-5600 - Mailing address
-
Po Box 735044
Chicago, IL 606735044
Credentials & registration
- NPI registered
- December 2006 — 20 yrs on file
- Profile last updated
- August 28, 2024
- Specialty taxonomy
- 363L00000X — NUCC code
- State licenses (2)
- Wisconsin #6437 · Missouri #1999139490
- Medicaid
- WI #100046653
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1811052319. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$31
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Organon Llc | 1 | $31.06 |
By nature of payment
Frequently asked questions
What is Dr. Jacqueline Stark's medical specialty?
Dr. Jacqueline Stark practices Nurse Practitioner in Pleasant Prairie, WI.
Where does Dr. Jacqueline Stark practice?
Dr. Jacqueline Stark practices at 12500 Aurora Dr, Pleasant Prairie, WI 531581227. Office phone: 2628575000.
What is Dr. Jacqueline Stark's NPI?
Dr. Jacqueline Stark's National Provider Identifier (NPI) is 1811052319, issued by NPPES.