Healthcare Provider Details

I. General information

NPI: 1497123715
Provider Name (Legal Business Name): CANDICE STEWART N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2015
Last Update Date: 03/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 S GILBERT RD STE 18
CHANDLER AZ
85286-1589
US

IV. Provider business mailing address

7001 N SCOTTSDALE RD STE 164
PARADISE VALLEY AZ
85253-3661
US

V. Phone/Fax

Practice location:
  • Phone: 480-963-5112
  • Fax:
Mailing address:
  • Phone: 480-306-7766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP7932
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: