Provider Demographics
NPI:1083485999
Name:STELLAR HEALTH LLC
Entity Type:Organization
Organization Name:STELLAR HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:SIMONE
Authorized Official - Last Name:BERNARD
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:571-442-4665
Mailing Address - Street 1:2020 N ACADEMY BLVD
Mailing Address - Street 2:SUITE 261, #2618
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1567
Mailing Address - Country:US
Mailing Address - Phone:571-442-4665
Mailing Address - Fax:940-301-3550
Practice Address - Street 1:2020 N ACADEMY BLVD
Practice Address - Street 2:SUITE 261, #2618
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1567
Practice Address - Country:US
Practice Address - Phone:571-442-4665
Practice Address - Fax:940-301-3550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty