Provider Demographics
NPI:1538830559
Name:STEWART, JONI PALMER (FNP-C)
Entity type:Individual
Prefix:
First Name:JONI
Middle Name:PALMER
Last Name:STEWART
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JONI
Other - Middle Name:MICHELE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:18260 HIGHWAY 15 N
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39339-6465
Mailing Address - Country:US
Mailing Address - Phone:662-803-0681
Mailing Address - Fax:
Practice Address - Street 1:4715 24TH PL
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-1686
Practice Address - Country:US
Practice Address - Phone:601-696-6736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904834363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily