Provider Demographics
NPI:1740387653
Name:STEWART, MERRY ANN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:MERRY
Middle Name:ANN
Last Name:STEWART
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:465 N BELAIR RD
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-3188
Mailing Address - Country:US
Mailing Address - Phone:706-774-7400
Mailing Address - Fax:706-774-7590
Practice Address - Street 1:465 N BELAIR RD
Practice Address - Street 2:SUITE 2B
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3188
Practice Address - Country:US
Practice Address - Phone:706-774-7400
Practice Address - Fax:706-774-7590
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN205580363LF0000X
MI4704115351363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily