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General NPI Number Information
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NPI Number | 1194266528
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Entity Type | Individual
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Provider Name | JANET STEWART
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Gender | Female
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Dates
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Enumeration Date | 03/18/2017
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Last Update Date | 03/18/2017
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Provider Practice Location Address
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Address Line | 1620 SCIVALLY DR
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63701-2431
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Country | US
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Telephone | 573-979-9612
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Fax | 573-339-0223
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Provider Business Mailing Address
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Address Line | 1620 SCIVALLY DR
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63701-2431
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Country | US
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Telephone | 573-979-9612
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Fax | 573-339-0223
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2016014612
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License Number State | MO
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