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Organization
STELLAR CARE LLC
Active
Organization
STELLAR CARE LLC
Active
Other names
Stellar Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANNA MARIE JOHNSON NP (PRESIDENT)
(414) 573-0179
Entity
Organization
Contact information
Practice address
10625 W NORTH AVE STE 230, MILWAUKEE, WI 53226-2315
(414) 249-5698
(320) 207-5719
Mailing address
10625 W NORTH AVE STE 230, WAUWATOSA, WI 53226-2315
(414) 249-5698
(320) 207-5719
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386940575
—
WI
Enumeration date
06/04/2021
Last updated
05/30/2024
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