| NPI | 1255121331 |
|---|---|
| Former Legal Business Name | STARDUST WOUND CARE INC |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE M HOWARD Nurse Practitioner 219-255-4719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-05-12 |