MEDICARE: BARBARA ANNE STEWART ANP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner		OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134129133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA ANNE STEWART ANP

Provider Business Mailing Address
First Line	:	107 FLORENCE AVE
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97504-7539
Country	:	US
Telephone Number	:	541-772-3776
Fax Number	:	541-772-8890

Provider Business Practice Location Address
First Line	:	2960 DOCTORS PARK DR
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97504-8127
Country	:	US
Telephone Number	:	541-770-0237
Fax Number	:	541-665-0727

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2005
Last Update Date	:	07/08/2007

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