Provider Demographics
NPI:1952754814
Name:STEWART, TAYLOR SIOBHAN (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:SIOBHAN
Last Name:STEWART
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:SIOBHAN
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:13215 LOMA VALLEJO
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-2418
Mailing Address - Country:US
Mailing Address - Phone:210-854-5473
Mailing Address - Fax:
Practice Address - Street 1:8200 PERRIN BEITEL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-1547
Practice Address - Country:US
Practice Address - Phone:210-967-1855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130893363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily