Provider Demographics
NPI:1881948750
Name:STEWART, CHRISTY B (RN,MSN,FNP-BC)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:B
Last Name:STEWART
Suffix:
Gender:F
Credentials:RN,MSN,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 PALUXY RD STE 205
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-5689
Mailing Address - Country:US
Mailing Address - Phone:817-759-7000
Mailing Address - Fax:817-759-7027
Practice Address - Street 1:3455 LOCKE AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-5719
Practice Address - Country:US
Practice Address - Phone:817-529-6200
Practice Address - Fax:817-377-5229
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-31
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX722939363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2012023045OtherANCC CERTIFICATION
TX722939OtherRN LICENSE #