Provider Demographics
NPI:1356862726
Name:DELGADILLO, STELLA (RN, ND)
Entity Type:Individual
Prefix:DR
First Name:STELLA
Middle Name:
Last Name:DELGADILLO
Suffix:
Gender:F
Credentials:RN, ND
Other - Prefix:DR
Other - First Name:ESTRELLA-STELLA
Other - Middle Name:
Other - Last Name:DELGADILLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, ND
Mailing Address - Street 1:1060 KAYLIE ST
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7116
Mailing Address - Country:US
Mailing Address - Phone:817-874-1417
Mailing Address - Fax:
Practice Address - Street 1:3901 ARLINGTON HIGHLANDS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-6050
Practice Address - Country:US
Practice Address - Phone:682-422-4746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-06
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X
TX679190163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679190OtherBOARD OF NURSING