MEDICARE: BARBARA KAY STUART NP-C

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	363LF0000X	Family Nurse Practitioner	192682-8900	UT

General Provider Information

NPI Number	:	1518265750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA KAY STUART NP-C

Provider Business Mailing Address
First Line	:	4118 N 190 W
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-4968
Country	:	US
Telephone Number	:	801-802-8824
Fax Number	:

Provider Business Practice Location Address
First Line	:	1273 W 12600 S
Second Line	:
City	:	RIVERTON
State	:	UT
Zip	:	84065-7111
Country	:	US
Telephone Number	:	801-254-9670
Fax Number	:

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

Provider Enumeration Date	:	03/12/2011
Last Update Date	:	03/12/2011

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