Healthcare Provider Details

I. General information

NPI: 1811106610
Provider Name (Legal Business Name): SANDRA LEE STELLA R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4788 W CENTER DR
HURLEY WI
54534-9313
US

IV. Provider business mailing address

4788 W CENTER DR
HURLEY WI
54534-9313
US

V. Phone/Fax

Practice location:
  • Phone: 715-561-2319
  • Fax:
Mailing address:
  • Phone: 715-561-2319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: