MEDICARE: KATHERINE ELIZABETH STEWART CRNP

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	SP033770	PA

General Provider Information

NPI Number	:	1093680860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE ELIZABETH STEWART CRNP

Provider Business Mailing Address
First Line	:	4150 BARRETT BLVD STE 200
Second Line	:
City	:	EPHRATA
State	:	PA
Zip	:	17522-8979
Country	:	US
Telephone Number	:	717-738-5648
Fax Number	:

Provider Business Practice Location Address
First Line	:	4150 BARRETT BLVD STE 200
Second Line	:
City	:	EPHRATA
State	:	PA
Zip	:	17522-8979
Country	:	US
Telephone Number	:	717-738-5648
Fax Number	:

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

Provider Enumeration Date	:	10/09/2025
Last Update Date	:	12/12/2025

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