Provider Demographics
NPI:1255187597
Name:STELLY, DESIREE A (DNP, MBA, MSN, CLNC)
Entity type:Individual
Prefix:DR
First Name:DESIREE
Middle Name:A
Last Name:STELLY
Suffix:
Gender:F
Credentials:DNP, MBA, MSN, CLNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 740876
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70174-0876
Mailing Address - Country:US
Mailing Address - Phone:504-610-8476
Mailing Address - Fax:
Practice Address - Street 1:3100 GENERAL DEGAULLE DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-6632
Practice Address - Country:US
Practice Address - Phone:504-535-2940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN138610163WA2000X, 163WC1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator