Provider Demographics
NPI:1679964688
Name:STEWART, DAVID (FNP-C PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:STEWART
Suffix:
Gender:M
Credentials:FNP-C PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MCINTOSH CT
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-9727
Mailing Address - Country:US
Mailing Address - Phone:302-363-6807
Mailing Address - Fax:
Practice Address - Street 1:21444 CARMEAN WAY
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-4572
Practice Address - Country:US
Practice Address - Phone:302-855-1233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-12
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000826363LF0000X
MDAC003915363LP0808X
DEL8-0010264363LP0808X
MDAC001477363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health