MEDICARE: CARY LEE 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
1	363LF0000X	Family Nurse Practitioner	01051703A	IN

General Provider Information

NPI Number	:	1548250962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARY LEE STEWART FNP

Provider Business Mailing Address
First Line	:	PO BOX 2227
Second Line	:
City	:	SKYLAND
State	:	NC
Zip	:	28776-2227
Country	:	US
Telephone Number	:	828-575-2644
Fax Number	:	828-350-2174

Provider Business Practice Location Address
First Line	:	3266 N MERIDIAN ST STE 900
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-5834
Country	:	US
Telephone Number	:	317-924-8297
Fax Number	:	317-924-8239

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

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	06/26/2015

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