Provider Demographics
NPI:1831502806
Name:MACEY-STEWART, KAREN VANESSA (MSN, APN-C)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:VANESSA
Last Name:MACEY-STEWART
Suffix:
Gender:F
Credentials:MSN, APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 OVERLOOK RD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-3570
Mailing Address - Country:US
Mailing Address - Phone:908-598-1500
Mailing Address - Fax:908-598-0197
Practice Address - Street 1:33 OVERLOOK RD
Practice Address - Street 2:SUITE 311
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3570
Practice Address - Country:US
Practice Address - Phone:908-598-1500
Practice Address - Fax:908-598-0197
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-08
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR00493100251G00000X, 367500000X
LA204825363LA2200X
NJ26NJ00493100363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No251G00000XAgenciesHospice Care, Community Based
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQHOther12746371