Provider Demographics
NPI:1831424761
Name:STEWART, LAURA (FNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 13TH AVE SE STE B
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-4316
Mailing Address - Country:US
Mailing Address - Phone:256-973-5216
Mailing Address - Fax:256-973-3177
Practice Address - Street 1:1005 W MARKET ST
Practice Address - Street 2:SUITE 7
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2454
Practice Address - Country:US
Practice Address - Phone:256-233-5000
Practice Address - Fax:256-233-5361
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-103660363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily