Provider Demographics
NPI:1023298791
Name:STEWART, LORRAINE E (APN)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:E
Last Name:STEWART
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 CATALINA MARIE AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-0608
Mailing Address - Country:US
Mailing Address - Phone:702-454-4515
Mailing Address - Fax:
Practice Address - Street 1:3490 MARTIN LUTHER KING BLVD.
Practice Address - Street 2:SUITE 105
Practice Address - City:N. LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032
Practice Address - Country:US
Practice Address - Phone:702-642-3313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN00533363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health