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General NPI Number Information
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NPI Number | 1679582555
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Entity Type | Individual
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Provider Name | SUSAN ELAINE STEWART NP
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Gender | Female
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1601 SW ARCHER RD MALCOLM RANDAL VETERANS MEDICAL CENTER
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City | GAINESVILLE
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State | FL
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Zip | 32608
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Country | US
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Telephone | 352-376-1611
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Fax |
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Provider Business Mailing Address
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Address Line | 18 NW 36TH DR
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City | GAINESVILLE
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State | FL
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Zip | 32607-6400
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Country | US
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Telephone | 352-371-7371
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP 1379672
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License Number State | FL
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