# STELLAR CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Stellar Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750958104
- **Authorized official:** MS. SHANNA MARIE JOHNSON NP (PRESIDENT)
- **Authorized official phone:** (414) 573-0179

## Contact information

- **Practice address:** 10625 W NORTH AVE STE 230, MILWAUKEE, WI 53226-2315
- **Practice address phone:** (414) 249-5698
- **Practice address fax:** (320) 207-5719
- **Mailing address:** 10625 W NORTH AVE STE 230, WAUWATOSA, WI 53226-2315
- **Mailing address phone:** (414) 249-5698
- **Mailing address fax:** (320) 207-5719

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |

## Other

- **Enumeration date:** 06/04/2021
- **Last updated:** 05/30/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1386940575 | — | WI |