MEDICARE: VIRGINIA STEWART APRN

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	2240852	FL

General Provider Information

NPI Number	:	1346541190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA STEWART APRN

Provider Business Mailing Address
First Line	:	6542 TRIEST AVE
Second Line	:
City	:	KEYSTONE HEIGHTS
State	:	FL
Zip	:	32656-9393
Country	:	US
Telephone Number	:	352-473-7288
Fax Number	:

Provider Business Practice Location Address
First Line	:	6542 TRIEST AVE
Second Line	:
City	:	KEYSTONE HEIGHTS
State	:	FL
Zip	:	32656-9393
Country	:	US
Telephone Number	:	352-473-7288
Fax Number	:

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

Provider Enumeration Date	:	11/10/2010
Last Update Date	:	11/10/2010

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Directions to “ VIRGINIA STEWART APRN” Practice Location

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