Healthcare Provider Details

I. General information

NPI: 1740568815
Provider Name (Legal Business Name): DEBORAH MARGARET STEWART FNP-C, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2011
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 MERCY LN
AURORA IL
60506-2447
US

IV. Provider business mailing address

229 LARUE LN
COLLINS GA
30421-6638
US

V. Phone/Fax

Practice location:
  • Phone: 877-381-6538
  • Fax: 877-381-6538
Mailing address:
  • Phone: 912-577-5372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN124133
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN124133
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN124133
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number277003688
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: