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General NPI Number Information
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NPI Number | 1710325956
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Entity Type | Organization
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Legal Business Name | ANDRE B STEWART, LLC
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Dates
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Enumeration Date | 06/10/2013
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Last Update Date | 06/10/2013
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Provider Practice Location Address
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Address Line | 10425 PLAZA AMERICANA DR
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City | BATON ROUGE
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State | LA
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Zip | 70816-8188
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Country | US
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Telephone | 225-810-4719
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 82677
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City | BATON ROUGE
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State | LA
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Zip | 70884-2677
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Country | US
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Telephone | 225-243-4554
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Fax | 225-243-4554
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANDRE B STEWART
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Credential | NP
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Telephone | 225-806-1956
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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 | RN095097
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License Number State | LA
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