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General NPI Number Information
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NPI Number | 1144730565
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Entity Type | Individual
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Provider Name | SIMONE ODETTA STEWART AANP
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Gender | Female
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Dates
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Enumeration Date | 10/11/2017
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 345 JUPITER LAKES BLVD STE 200
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City | JUPITER
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State | FL
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Zip | 33458-7100
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Country | US
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Telephone | 561-741-1957
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Fax |
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Provider Business Mailing Address
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Address Line | 345 JUPITER LAKES BLVD STE 200
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City | JUPITER
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State | FL
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Zip | 33458-7100
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Country | US
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Telephone | 954-263-2248
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Fax | 561-423-5883
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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 | 163WX0003X
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Taxonomy Name | Inpatient Obstetric Registered Nurse
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License Number | APRN3177382
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN3177382
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License Number State | FL
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