Provider Demographics
NPI:1942535497
Name:STEWART, ANNA K (APRN)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:K
Last Name:STEWART
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:225 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-7914
Mailing Address - Country:US
Mailing Address - Phone:270-441-4200
Mailing Address - Fax:270-441-4249
Practice Address - Street 1:1532 LONE OAK RD
Practice Address - Street 2:SUITE 315
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7913
Practice Address - Country:US
Practice Address - Phone:270-538-5880
Practice Address - Fax:270-538-5870
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2015-10-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY6224S363LF0000X
KY3006224364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100117320Medicaid
KYK034781Medicare PIN