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General NPI Number Information
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NPI Number | 1215615307
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Entity Type | Individual
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Provider Name | KATRINA STEWART NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 07/07/2023
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 1 GUSTAVE L LEVY PL FL 12
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City | NEW YORK
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State | NY
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Zip | 10029-6574
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Country | US
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Telephone | 212-241-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 1146 FOREST AVE
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City | BRONX
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State | NY
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Zip | 10456-5478
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Country | US
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Telephone | 336-669-7357
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 404687
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F404687-01
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License Number State | NY
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