Provider Demographics
NPI:1992452411
Name:STEWART, BRETT ALLEN (NP-C)
Entity type:Individual
Prefix:MR
First Name:BRETT
Middle Name:ALLEN
Last Name:STEWART
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1669 W INA RD STE 141
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-1981
Mailing Address - Country:US
Mailing Address - Phone:520-795-6183
Mailing Address - Fax:
Practice Address - Street 1:1669 W INA RD STE 141
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1981
Practice Address - Country:US
Practice Address - Phone:520-795-6183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-04
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ221409363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health