Healthcare Provider Details

I. General information

NPI: 1396153797
Provider Name (Legal Business Name): DARRYL STEWART AGPCNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2014
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 PENNSYLVANIA AVE SE STE 205
WASHINGTON DC
20020-3731
US

IV. Provider business mailing address

1015 RIPLEY ST APT 402
SILVER SPRING MD
20910-7479
US

V. Phone/Fax

Practice location:
  • Phone: 202-796-9775
  • Fax:
Mailing address:
  • Phone: 301-325-7758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberR189085
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberR189085
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR189085
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: