Provider Demographics
NPI:1407246838
Name:STEWART, FELMER (CRNP)
Entity Type:Individual
Prefix:
First Name:FELMER
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 W ANKLAM RD STE 104
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2690
Mailing Address - Country:US
Mailing Address - Phone:520-624-8935
Mailing Address - Fax:
Practice Address - Street 1:1714 W ANKLAM RD STE 104
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2690
Practice Address - Country:US
Practice Address - Phone:520-624-8935
Practice Address - Fax:520-625-0063
Is Sole Proprietor?:No
Enumeration Date:2015-01-23
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014470363L00000X
FLAPRN11020146363L00000X
WVAPRN63085NP363L00000X
AZAP9693363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ324606Medicaid
FL116546500Medicaid
FLQB596OtherHF MA