Basic Information
| Provider Information | |||||||||
| NPI: | 1679964688 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEWART | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
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| Credential: | FNP-C PMHNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9 MCINTOSH CT | ||||||||
| Address2: | |||||||||
| City: | LEWES | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199589727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023636807 | ||||||||
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| Practice Location | |||||||||
| Address1: | 21444 CARMEAN WAY | ||||||||
| Address2: | |||||||||
| City: | GEORGETOWN | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199474572 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3028551233 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2015 | ||||||||
| LastUpdateDate: | 11/09/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | LG-0000826 | DE | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LP0808X | AC003915 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LP0808X | L8-0010264 | DE | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LF0000X | AC001477 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.