Individual
STELLA DIANE FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 WALNUT ST., ELLINGTON, MO 63638-0157
(573) 663-2313
(573) 663-7821
Mailing address
PO BOX 117, ELLINGTON, MO 63638-0117
(573) 558-2359
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
09/05/2006
Last updated
07/08/2007
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