Provider Demographics
NPI:1508457359
Name:BERNARD, STELLA SIMONE (FNP)
Entity type:Individual
Prefix:
First Name:STELLA
Middle Name:SIMONE
Last Name:BERNARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 N DYSART RD STE 202
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-3036
Mailing Address - Country:US
Mailing Address - Phone:602-888-2333
Mailing Address - Fax:602-888-2334
Practice Address - Street 1:5115 N DYSART RD STE 202
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-3036
Practice Address - Country:US
Practice Address - Phone:602-888-2344
Practice Address - Fax:602-888-2334
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ255290363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily