Provider Demographics
NPI:1679231849
Name:STELLAR HEALTH AND WELLNESS AESTHETICS AND BEAUTY, LLC
Entity Type:Organization
Organization Name:STELLAR HEALTH AND WELLNESS AESTHETICS AND BEAUTY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ HEAD CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HORNER
Authorized Official - Suffix:
Authorized Official - Credentials:ANP
Authorized Official - Phone:907-952-0770
Mailing Address - Street 1:4138 BRANTLEY PL
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5319
Mailing Address - Country:US
Mailing Address - Phone:907-538-7144
Mailing Address - Fax:844-880-8349
Practice Address - Street 1:4138 BRANTLEY PL
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5319
Practice Address - Country:US
Practice Address - Phone:907-538-7144
Practice Address - Fax:907-339-3703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty