Provider Demographics
NPI:1902574379
Name:STUARD, YSABELLE (APRN)
Entity type:Individual
Prefix:MS
First Name:YSABELLE
Middle Name:
Last Name:STUARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:CT
Mailing Address - Zip Code:06524-3531
Mailing Address - Country:US
Mailing Address - Phone:303-818-0355
Mailing Address - Fax:
Practice Address - Street 1:15 CARRINGTON RD
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:CT
Practice Address - Zip Code:06524-3531
Practice Address - Country:US
Practice Address - Phone:303-818-0355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12.009933363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily