Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jerry Randall Stark, RN

Individual provider Emergency Registered Nurse · NPI 1447507066

Jerry Randall Stark, RN is an Emergency Registered Nurse in Southaven, Mississippi. Licensed in Mississippi. Registered with an NPI since 2012.

Licensed in
MS
In the registry since
2012
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

See every abbreviation used in this directory →

Practice location Address checks out

848 Valley Springs Dr
Southaven, MS 38671-4336
Phone: (901) 337-7778
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Registered Nurse (primary) Taxonomy 163WE0003X · Licence R881245 (MS)

Record details

NPI number1447507066
Entity typeIndividual (Type 1)
GenderMale
Credentials RN
Sole proprietorNo
NPI enumeratedAugust 14, 2012
Last updated in NPPESAugust 14, 2012
Mailing address848 Valley Springs Dr, Southaven, MS 38671-4336