Provider Demographics
NPI:1255121331
Name:STARDUST HEALTH & WOUND CARE INC
Entity type:Organization
Organization Name:STARDUST HEALTH & WOUND CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:219-255-4719
Mailing Address - Street 1:609 W 77TH AVE
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5776
Mailing Address - Country:US
Mailing Address - Phone:219-512-1318
Mailing Address - Fax:219-255-4719
Practice Address - Street 1:5490 BROADWAY STE 107
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-1676
Practice Address - Country:US
Practice Address - Phone:219-255-4719
Practice Address - Fax:219-255-4719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty