Healthcare Provider Details

I. General information

NPI: 1033403381
Provider Name (Legal Business Name): ALISHA MARIE STEWART FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2011
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3905 OBERLIN AVE
LORAIN OH
44053-2853
US

IV. Provider business mailing address

3905 OBERLIN AVE
LORAIN OH
44053-2853
US

V. Phone/Fax

Practice location:
  • Phone: 330-486-6092
  • Fax: 440-930-7833
Mailing address:
  • Phone: 330-486-6092
  • Fax: 440-930-7833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA. 12272-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: