Healthcare Provider Details

I. General information

NPI: 1730814518
Provider Name (Legal Business Name): ASHLEY NICOLE STEWART ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E SAMPLE RD
DEERFIELD BEACH FL
33064-3502
US

IV. Provider business mailing address

90 NOTTINGHAM PL
BOYNTON BEACH FL
33426-8428
US

V. Phone/Fax

Practice location:
  • Phone: 954-941-8300
  • Fax:
Mailing address:
  • Phone: 917-569-9057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11021818
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: