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General NPI Number Information
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NPI Number | 1396871612
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Entity Type | Individual
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Provider Name | BETTY ANN STEWART LPN
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Gender | Female
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2665 SEXTON RD
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City | GENEVA
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State | OH
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Zip | 44041-9230
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Country | US
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Telephone | 440-466-7710
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Fax |
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Provider Business Mailing Address
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Address Line | 19427 SHERMANSVILLE RD
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City | CONNEAUTVILLE
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State | PA
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Zip | 16406-2425
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Country | US
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Telephone | 814-587-3308
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN070963
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License Number State | OH
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