STELLA MEDICAL CENTER LLC NPI 1558773002

NPI Information

  • NPI: 1558773002
  • Provider Name: STELLA MEDICAL CENTER LLC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • CLIA Number: 11D2080777
  • Address: 2121 FAIRBURN RD
    SUITE B
    DOUGLASVILLE, GA
    ZIP 30135
  • Phone: (678) 594-3881

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NPI Details

STELLA MEDICAL CENTER LLC is a family nurse practitioner in Douglasville, GA. STELLA MEDICAL CENTER LLC NPI is 1558773002. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2121 FAIRBURN RD
SUITE B
DOUGLASVILLE, GA
ZIP 30135-007
Phone: (678) 594-3881
Fax: (687) 594-3871

The provider's authorized official is Caroline C Anaele .
The authorized official title is Family Nurse Practitioner and has the following contact phone number (678) 594-3881.

The CLIA number assigned to this NPI record is 11D2080777 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/2/2014 and was last updated on 6/2/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyRN135346GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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