Healthcare Provider Details

I. General information

NPI: 1912870064
Provider Name (Legal Business Name): SARAH ANNE STEWART PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 RONALD REAGAN PKWY
AVON IN
46123-7085
US

IV. Provider business mailing address

545 BARNHILL DR STE 232
INDIANAPOLIS IN
46202-5112
US

V. Phone/Fax

Practice location:
  • Phone: 317-944-3636
  • Fax:
Mailing address:
  • Phone: 317-944-3636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10005068A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: