Provider Demographics
NPI:1407209455
Name:DURU, STELLA JULIET (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:STELLA
Middle Name:JULIET
Last Name:DURU
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:CHIOMA
Other - Middle Name:JULIET
Other - Last Name:OKWO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:261 TWAIN CIR SE
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-5244
Mailing Address - Country:US
Mailing Address - Phone:404-667-9960
Mailing Address - Fax:
Practice Address - Street 1:261 TWAIN CIR SE
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-5244
Practice Address - Country:US
Practice Address - Phone:404-667-9960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA106275163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse