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General NPI Number Information
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NPI Number | 1508457359
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Entity Type | Individual
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Provider Name | STELLA SIMONE BERNARD FNP
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Gender | Female
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Dates
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Enumeration Date | 02/02/2021
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 5115 N DYSART RD STE 202
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-3036
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Country | US
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Telephone | 602-888-2344
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Fax | 602-888-2334
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Provider Business Mailing Address
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Address Line | 5115 N DYSART RD STE 202
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-3036
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Country | US
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Telephone | 602-888-2333
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Fax | 602-888-2334
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 255290
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License Number State | AZ
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