Healthcare Provider Details

I. General information

NPI: 1336956630
Provider Name (Legal Business Name): SARA MUNROE STEWART CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3855 PLEASANT HILL RD STE 480
DULUTH GA
30096-8030
US

IV. Provider business mailing address

3855 PLEASANT HILL RD STE 480
DULUTH GA
30096-8030
US

V. Phone/Fax

Practice location:
  • Phone: 770-623-6433
  • Fax: 770-623-6416
Mailing address:
  • Phone: 770-623-6433
  • Fax: 770-623-6416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN-NP214082
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: