Provider Demographics
NPI:1467885384
Name:STELLAR HEALTHCARE LLC
Entity Type:Organization
Organization Name:STELLAR HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:STOGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-294-4747
Mailing Address - Street 1:5045 OLD HICKORY BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2582
Mailing Address - Country:US
Mailing Address - Phone:615-884-6466
Mailing Address - Fax:615-953-6834
Practice Address - Street 1:5045 OLD HICKORY BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2582
Practice Address - Country:US
Practice Address - Phone:615-884-6466
Practice Address - Fax:615-953-6834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17056363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty