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

MS. Jacqueline A Stark, CPNP

Individual provider Pediatric Nurse Practitioner · NPI 1811052319

MS. Jacqueline A Stark, CPNP is a Pediatric Nurse Practitioner in Pleasant Prairie, Wisconsin. Works from 2 locations. Licensed in Missouri and Wisconsin.

Licensed in
MO, WI
In the registry since
2006
Specialties on file
3
What do these letters mean?
CPNP — Certified Pediatric Nurse Practitioner
A nurse practitioner certified in paediatrics.

See every abbreviation used in this directory →

Practice location Address checks out

12500 Aurora Dr
Pleasant Prairie, WI 53158-1227
Phone: (262) 857-5000
Fax: (262) 857-5001
Show map & directions

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

Additional practice locations (1)

  • 10400 75th St, Kenosha, WI 53142-7884 — (262) 948-5600

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 6437 (WI)
Pediatric Nurse Practitioner Taxonomy 363LP0200X · Licence 6437 (WI)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 1999139490 (MO)

Record details

NPI number1811052319
Entity typeIndividual (Type 1)
GenderFemale
Credentials CPNP
Sole proprietorNo
NPI enumeratedDecember 26, 2006
Last updated in NPPESAugust 28, 2024
Certification dateAugust 28, 2024

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