Provider Demographics
NPI:1922866292
Name:STEWART, TASIA (APRN,FNP-BC)
Entity Type:Individual
Prefix:
First Name:TASIA
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:APRN,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-5615
Mailing Address - Country:US
Mailing Address - Phone:563-639-8138
Mailing Address - Fax:
Practice Address - Street 1:918 E 10TH ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-5615
Practice Address - Country:US
Practice Address - Phone:563-639-8138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA177834363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily