Provider Demographics
NPI:1114173085
Name:STEWART, ANGELA D (CRNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:D
Last Name:STEWART
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:51 N 39TH ST
Mailing Address - Street 2:2 PHI
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2640
Mailing Address - Country:US
Mailing Address - Phone:215-662-9010
Mailing Address - Fax:
Practice Address - Street 1:5501 OLD YORK RD
Practice Address - Street 2:DEPARTMENT OF CARDIOLOGY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3018
Practice Address - Country:US
Practice Address - Phone:215-456-3241
Practice Address - Fax:215-456-3533
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP008032363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine