Provider Demographics
NPI:1033767207
Name:STELLY, CHRISTINA (DNP, RN)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:STELLY
Suffix:
Gender:F
Credentials:DNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 S STATE ST APT 803
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-1653
Mailing Address - Country:US
Mailing Address - Phone:702-343-0791
Mailing Address - Fax:
Practice Address - Street 1:520 S STATE ST APT 803
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-1653
Practice Address - Country:US
Practice Address - Phone:702-343-0791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95100961163W00000X
TX821169163W00000X
IL041.469080163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse