Provider Demographics
NPI:1659997377
Name:STEWART, AMBER R (CNP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:R
Last Name:STEWART
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:ROSE
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:655 AFRICA RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-9808
Mailing Address - Country:US
Mailing Address - Phone:614-865-3172
Mailing Address - Fax:614-865-2781
Practice Address - Street 1:655 AFRICA RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-9808
Practice Address - Country:US
Practice Address - Phone:614-865-3172
Practice Address - Fax:614-865-2781
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-18
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0026912363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily