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NPI Code Detail

MEDICARE: ALLYSON D STEWART APRN

MEDICARE:   ALLYSON D STEWART  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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner26274TN

General Provider Information

NPI Number : 1225685142
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLYSON D STEWART APRN
Provider Business Mailing Address
First Line : 7407 LIVE OAK MANOR CV
Second Line :
City : OLIVE BRANCH
State : MS
Zip : 38654-1294
Country : US
Telephone Number : 901-201-1473
Fax Number :
Provider Business Practice Location Address
First Line : 5865 RIDGEWAY CENTER PKWY STE 300
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-4014
Country : US
Telephone Number : 901-201-1473
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2019
Last Update Date : 09/08/2023

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