MEDICARE: MARK STELLE APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1220613	TX

General Provider Information

NPI Number	:	1699630996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK STELLE APRN

Provider Business Mailing Address
First Line	:	6607 BRODIE LN APT 816
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-4652
Country	:	US
Telephone Number	:	512-717-1617
Fax Number	:

Provider Business Practice Location Address
First Line	:	6607 BRODIE LN APT 816
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-4652
Country	:	US
Telephone Number	:	512-717-1617
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2025
Last Update Date	:	12/18/2025

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Directions to “ MARK STELLE APRN” Practice Location

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