Provider Demographics
NPI:1982345880
Name:STEWART, ALEXANDRA N (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:N
Last Name:STEWART
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 EAGLERIDGE BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81008-2354
Mailing Address - Country:US
Mailing Address - Phone:316-655-1470
Mailing Address - Fax:
Practice Address - Street 1:805 EAGLERIDGE BLVD STE 140
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2354
Practice Address - Country:US
Practice Address - Phone:719-679-5022
Practice Address - Fax:719-888-1673
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0997439363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health