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General NPI Number Information
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NPI Number | 1093029993
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Entity Type | Individual
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Provider Name | ANGELA MARIE STEWART CRNP, RN FA
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Gender | Female
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Dates
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Enumeration Date | 08/03/2010
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Last Update Date | 09/06/2013
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Provider Practice Location Address
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Address Line | 575 N RIVER ST
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City | WILKES BARRE
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State | PA
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Zip | 18764-0999
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Country | US
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Telephone | 570-829-8111
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Fax | 845-454-6080
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Provider Business Mailing Address
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Address Line | 575 N RIVER ST
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City | WILKES BARRE
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State | PA
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Zip | 18764-0999
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Country | US
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Telephone | 570-829-8111
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Fax | 845-454-6080
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 547571
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | RN528629L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 305888
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | SP012771
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License Number State | PA
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