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General NPI Number Information
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NPI Number | 1699063248
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Entity Type | Individual
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Provider Name | KRISTAL RENAE STEWART FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/18/2011
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 670 MARGARET AVE
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City | TERRE HAUTE
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State | IN
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Zip | 47802
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Country | US
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Telephone | 812-232-1410
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Fax |
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Provider Business Mailing Address
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Address Line | 221 S 6TH ST
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City | TERRE HAUTE
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State | IN
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Zip | 47807-4214
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Country | US
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Telephone | 812-242-3109
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Fax | 812-242-3990
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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 | 28152110A
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License Number State | IN
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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 | 71003689A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71003689A
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License Number State | IN
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