Individual
MS. MARY VICTORIA STELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
(318) 629-4833
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0177
(318) 629-4833
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP04748
LA
363LF0000X
Family Nurse Practitioner
Primary
AP04748
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1721051
—
LA
Enumeration date
06/13/2006
Last updated
01/11/2023
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