# STELLA MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164841516
- **Authorized official:** CAROLINE ANAELE (OWNER)
- **Authorized official phone:** (770) 855-2308

## Contact information

- **Practice address:** 2121 FAIRBURN RD STE B, DOUGLASVILLE, GA 30135-1029
- **Practice address phone:** (770) 855-2308
- **Mailing address:** 2121 FAIRBURN RD STE B, DOUGLASVILLE, GA 30135-1029
- **Mailing address phone:** (770) 855-2308

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | RN135346 | GA | Yes |

## Other

- **Enumeration date:** 04/14/2014
- **Last updated:** 04/14/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 456441108E | — | GA |