Provider Demographics
NPI:1659891026
Name:HEALTHCARE, STELLAR (SERVICES)
Entity Type:Individual
Prefix:
First Name:STELLAR
Middle Name:
Last Name:HEALTHCARE
Suffix:
Gender:F
Credentials:SERVICES
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 934860
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33093-4860
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 SW 54TH AVE
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33068-3360
Practice Address - Country:US
Practice Address - Phone:954-394-6576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health