MEDICARE: STEPHANIE ANN STEWART LPN

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	164W00000X	Licensed Practical Nurse	P63702	IA

General Provider Information

NPI Number	:	1841038684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE ANN STEWART LPN

Provider Business Mailing Address
First Line	:	1825 QUAIL RUN LN
Second Line	:
City	:	CEDAR FALLS
State	:	IA
Zip	:	50613-4983
Country	:	US
Telephone Number	:	860-629-9276
Fax Number	:

Provider Business Practice Location Address
First Line	:	1825 QUAIL RUN LN
Second Line	:
City	:	CEDAR FALLS
State	:	IA
Zip	:	50613-4983
Country	:	US
Telephone Number	:	860-629-9276
Fax Number	:

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

Provider Enumeration Date	:	07/16/2024
Last Update Date	:	07/16/2024

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