Provider Demographics
NPI:1821781766
Name:STEWART, MADISON (DNP, APRN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:DNP, APRN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 LUTHER AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:AR
Mailing Address - Zip Code:72560-9732
Mailing Address - Country:US
Mailing Address - Phone:870-213-6029
Mailing Address - Fax:
Practice Address - Street 1:5901 RILEY PARK DR STE B
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72916-6104
Practice Address - Country:US
Practice Address - Phone:479-763-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR224500363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics