Provider Demographics
NPI:1730501818
Name:STEWARD, ELIZABETH (FNP-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:STEWARD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5379
Mailing Address - Street 2:
Mailing Address - City:WEST LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03784-5379
Mailing Address - Country:US
Mailing Address - Phone:207-977-4443
Mailing Address - Fax:931-208-3613
Practice Address - Street 1:170 COMMERCE WAY STE 200
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-3272
Practice Address - Country:US
Practice Address - Phone:207-977-4443
Practice Address - Fax:931-208-3613
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH086006-23363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1730501818Medicaid
ME1730501818Medicaid