Healthcare Provider Details

I. General information

NPI: 1235963158
Provider Name (Legal Business Name): JOSEPH MICHAEL STEWART PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2024
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10217 N METRO PKWY W
PHOENIX AZ
85051-1438
US

IV. Provider business mailing address

10217 N METRO PKWY W
PHOENIX AZ
85051-1438
US

V. Phone/Fax

Practice location:
  • Phone: 623-309-9803
  • Fax:
Mailing address:
  • Phone: 623-309-9803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number313639
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: