MEDICARE: LAURA ANN STEWART FNP

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209019423	IL
2	363LF0000X	Family Nurse Practitioner	3008585	KY
3	363LF0000X	Family Nurse Practitioner	71004212A	IN

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	P01613654	OTHER	IN	RAILROAD MEDICARE
7	1539357	OTHER	KY	WELLCARE MEDICARE OF KENTUCKY PROVIDER ID NUMBER
9	P02272271	OTHER	IL	RAILROAD MEDICARE
10	P02182197	OTHER	KY	RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000001013322	OTHER		ANTHEM PIN
3	9741978	OTHER		AETNA PROVIDER ID NUMBER
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	CS1806800260	OTHER		CARESOURCE ID
11	PDZ000000076282	OTHER	KY	AETNA BETTER HEALTH OF KENTUCKY PROVIDER ID NUMBER

NPI Number	:	1841543923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA ANN STEWART FNP

Provider Business Mailing Address
First Line	:	PO BOX 21890
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4115
Country	:	US
Telephone Number	:	502-907-0356
Fax Number	:	502-919-9780

Provider Business Practice Location Address
First Line	:	700 KIMBER LANE
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-2803
Country	:	US
Telephone Number	:	812-476-7111
Fax Number	:	812-476-7117

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

Provider Enumeration Date	:	10/26/2012
Last Update Date	:	02/13/2024