Healthcare Provider Details

I. General information

NPI: 1538826375
Provider Name (Legal Business Name): FIONA STUART CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2021
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 EWAN RD # E1
MULLICA HILL NJ
08062-3707
US

IV. Provider business mailing address

918 COUNTY LINE RD
BRYN MAWR PA
19010-2502
US

V. Phone/Fax

Practice location:
  • Phone: 856-341-8474
  • Fax:
Mailing address:
  • Phone: 610-525-6086
  • Fax: 610-525-1846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP024635
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number26NJ15563400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: