Provider Demographics
NPI:1396871612
Name:STEWART, BETTY ANN (LPN)
Entity type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:ANN
Last Name:STEWART
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19427 SHERMANSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CONNEAUTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16406-2425
Mailing Address - Country:US
Mailing Address - Phone:814-587-3308
Mailing Address - Fax:
Practice Address - Street 1:2665 SEXTON RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:OH
Practice Address - Zip Code:44041-9230
Practice Address - Country:US
Practice Address - Phone:440-466-7710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN070963164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse