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General NPI Number Information
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NPI Number | 1780294967
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Entity Type | Individual
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Provider Name | MARY STEWARDSON
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Gender | Female
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Dates
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Enumeration Date | 08/03/2020
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Last Update Date | 08/03/2020
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Provider Practice Location Address
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Address Line | 2408 S 37TH ST
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City | TEMPLE
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State | TX
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Zip | 76504-7168
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Country | US
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Telephone | 254-771-6750
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Fax | 254-778-0156
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Provider Business Mailing Address
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Address Line | 24934 STILLMAN VALLEY RD
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City | FLORENCE
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State | TX
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Zip | 76527-4808
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Country | US
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Telephone | 254-681-9213
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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 | 1007569
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License Number State | TX
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