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NPI Code Detail

MEDICARE: CHARISSE WILLIAMS-STEWART PMHNP

MEDICARE:   CHARISSE  WILLIAMS-STEWART  PMHNP
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
1363L00000XNurse PractitionerAPN.1000890-NPCO
2363L00000XNurse PractitionerRN803942PA
3363LP0808XPsychiatric/Mental Health Nurse Practitioner4704427298MI
4363LP0808XPsychiatric/Mental Health Nurse PractitionerAP70014167WA
5363LP0808XPsychiatric/Mental Health Nurse Practitioner403697NY
6363LP0808XPsychiatric/Mental Health Nurse Practitioner2025050948MO
7363LP0808XPsychiatric/Mental Health Nurse Practitioner0024194011VA
8363LP0808XPsychiatric/Mental Health Nurse Practitioner10046018OR
9363LP0808XPsychiatric/Mental Health Nurse PractitionerAPN.1000890-NPCO

General Provider Information

NPI Number : 1740948470
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARISSE WILLIAMS-STEWART PMHNP
Provider Business Mailing Address
First Line : 213 S JEFFERSON ST STE 1006
Second Line :
City : ROANOKE
State : VA
Zip : 24011-1713
Country : US
Telephone Number : 540-224-5372
Fax Number :
Provider Business Practice Location Address
First Line : 2017 JEFFERSON ST SW
Second Line :
City : ROANOKE
State : VA
Zip : 24014-2419
Country : US
Telephone Number : 540-981-8025
Fax Number : 540-853-0511
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2021
Last Update Date : 03/13/2026

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