Provider Demographics
NPI:1417258146
Name:STEWART, CASIE M (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CASIE
Middle Name:M
Last Name:STEWART
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:CASIE
Other - Middle Name:M
Other - Last Name:POINDEXTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1500 N WESTWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-3318
Mailing Address - Country:US
Mailing Address - Phone:573-760-1365
Mailing Address - Fax:573-760-0354
Practice Address - Street 1:1500 N WESTWOOD BLVD
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-3318
Practice Address - Country:US
Practice Address - Phone:573-760-1365
Practice Address - Fax:573-760-0354
Is Sole Proprietor?:No
Enumeration Date:2010-11-11
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA159496363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily