Provider Demographics
NPI:1760781033
Name:STELLAR HEALTHCARE, LTD
Entity Type:Organization
Organization Name:STELLAR HEALTHCARE, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ERDMANN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:701-364-3660
Mailing Address - Street 1:3274 51ST ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-7179
Mailing Address - Country:US
Mailing Address - Phone:701-364-3660
Mailing Address - Fax:701-364-3661
Practice Address - Street 1:3274 51ST ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-7179
Practice Address - Country:US
Practice Address - Phone:701-364-3660
Practice Address - Fax:701-364-3661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-25
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care