Provider Demographics
NPI:1043670466
Name:WOHLFARTH, STELLA (FNP-C, MSN)
Entity type:Individual
Prefix:MRS
First Name:STELLA
Middle Name:
Last Name:WOHLFARTH
Suffix:
Gender:F
Credentials:FNP-C, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 740019
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-0019
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:
Practice Address - Street 1:224 S WOODS MILL RD STE 435S
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3408
Practice Address - Country:US
Practice Address - Phone:314-576-2394
Practice Address - Fax:314-590-5937
Is Sole Proprietor?:No
Enumeration Date:2016-02-26
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA468363163W00000X
MO2021005093163WP2201X, 363LF0000X
CA95003274363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care