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NPI Code Detail

MEDICARE: MRS. MARY RUTH STEWART C.P.N.P.

MEDICARE: MRS. MARY RUTH STEWART C.P.N.P.
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
1363LP0200XPediatric Nurse Practitioner255889CA

General Provider Information

NPI Number : 1336331529
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY RUTH STEWART C.P.N.P.
Provider Business Mailing Address
First Line : 815 S WILLOW AVE
Second Line :
City : RIALTO
State : CA
Zip : 92376-6934
Country : US
Telephone Number : 909-820-4431
Fax Number : 909-820-7770
Provider Business Practice Location Address
First Line : 815 S WILLOW AVE
Second Line :
City : RIALTO
State : CA
Zip : 92376-6934
Country : US
Telephone Number : 909-820-4431
Fax Number : 909-820-7770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2007
Last Update Date : 08/13/2007

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Directions to “ MRS. MARY RUTH STEWART C.P.N.P.” Practice Location

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