Provider Demographics
NPI:1962138602
Name:STEWART, ALISSA MARIE (CNP)
Entity type:Individual
Prefix:MRS
First Name:ALISSA
Middle Name:MARIE
Last Name:STEWART
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 POTTERS CIR
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420-1221
Mailing Address - Country:US
Mailing Address - Phone:330-766-8488
Mailing Address - Fax:
Practice Address - Street 1:213 POTTERS CIR
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:OH
Practice Address - Zip Code:44420-1221
Practice Address - Country:US
Practice Address - Phone:330-766-8488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031926363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care