Provider Demographics
NPI:1730501818
Name:STEWARD, ELIZABETH (FNP-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:STEWARD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:180 CHURCH HILL RD
Mailing Address - Street 2:STE 1
Mailing Address - City:LEEDS
Mailing Address - State:ME
Mailing Address - Zip Code:04263-3418
Mailing Address - Country:US
Mailing Address - Phone:207-524-3501
Mailing Address - Fax:207-524-2459
Practice Address - Street 1:180 CHURCH HILL RD
Practice Address - Street 2:STE 1
Practice Address - City:LEEDS
Practice Address - State:ME
Practice Address - Zip Code:04263-3418
Practice Address - Country:US
Practice Address - Phone:207-524-3501
Practice Address - Fax:207-524-2459
Is Sole Proprietor?:No
Enumeration Date:2014-01-09
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP131117363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1730501818Medicaid
ME1730501818Medicaid