Healthcare Provider Details

I. General information

NPI: 1306124557
Provider Name (Legal Business Name): STACY J STEWART ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2011
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4325 WILLIAMS BLVD SW UNITYPOINT CLINIC FAMILY MEDICINE STE 100
CEDAR RAPIDS IA
52404
US

IV. Provider business mailing address

4325 WILLIAMS BLVD SW UNITYPOINT CLINIC FAMILY MEDICINE STE 100
CEDAR RAPIDS IA
52404
US

V. Phone/Fax

Practice location:
  • Phone: 319-368-8400
  • Fax: 319-368-8405
Mailing address:
  • Phone: 319-368-8400
  • Fax: 319-368-8405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number7675-33
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberA167135
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG178407
License Number StateIA
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA167135
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: