Provider Demographics
NPI:1548250962
Name:STEWART, CARY LEE (FNP)
Entity type:Individual
Prefix:
First Name:CARY
Middle Name:LEE
Last Name:STEWART
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CARY
Other - Middle Name:
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 2227
Mailing Address - Street 2:
Mailing Address - City:SKYLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28776-2227
Mailing Address - Country:US
Mailing Address - Phone:828-575-2644
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:3266 N MERIDIAN ST STE 900
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-5834
Practice Address - Country:US
Practice Address - Phone:317-924-8297
Practice Address - Fax:317-924-8239
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01051703A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0708303Medicare ID - Type Unspecified
KY0708302Medicare PIN
KY0708302Medicare PIN