Healthcare Provider Details

I. General information

NPI: 1639837347
Provider Name (Legal Business Name): EMMA STEWART FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2021
Last Update Date: 11/30/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7074 HARRISON AVE STE 6
CINCINNATI OH
45247-8301
US

IV. Provider business mailing address

427 DELTA AVE APT B1-21
CINCINNATI OH
45226-1192
US

V. Phone/Fax

Practice location:
  • Phone: 513-922-8200
  • Fax:
Mailing address:
  • Phone: 513-614-5066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0030252
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: