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General NPI Number Information
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NPI Number | 1770053936
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Entity Type | Individual
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Provider Name | MARY ELIZABETH STUART
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Gender | Female
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Dates
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Enumeration Date | 11/30/2018
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Last Update Date | 11/30/2018
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Provider Practice Location Address
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Address Line | 3100 HAWTHORNE DR
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City | DOVER
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State | DE
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Zip | 19901-5391
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Country | US
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Telephone | 302-674-9080
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Fax |
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Provider Business Mailing Address
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Address Line | 22023 REYNOLDS POND RD
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City | ELLENDALE
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State | DE
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Zip | 19941-2641
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Country | US
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Telephone | 215-665-0117
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | L1-0046204
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License Number State | DE
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