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NPI Code Detail

MEDICARE: JENNIFER M STEWART FNP

MEDICARE: JENNIFER M STEWART FNP
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
1363LF0000XFamily Nurse Practitioner71004920AIN

Other Identifiers

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

General Provider Information

NPI Number : 1255745303
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER M STEWART FNP
Provider Business Mailing Address
First Line : 5923 VICTORY AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46203-6921
Country : US
Telephone Number : 317-413-3433
Fax Number :
Provider Business Practice Location Address
First Line : 1545 N MERIDIAN ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2306
Country : US
Telephone Number : 317-923-1491
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2014
Last Update Date : 01/09/2024

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