Provider Demographics
NPI:1780810887
Name:STEWART, RACHEL ANNE (FNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANNE
Last Name:STEWART
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4160 HERITAGE TRACE PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-5313
Mailing Address - Country:US
Mailing Address - Phone:817-431-6160
Mailing Address - Fax:817-562-1351
Practice Address - Street 1:4160 HERITAGE TRACE PKWY STE 400
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-5313
Practice Address - Country:US
Practice Address - Phone:817-431-6160
Practice Address - Fax:817-562-1351
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2023-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN160537363LF0000X
TX783128363LF0000X
TXAP118955363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN160537OtherGEORGIA BOARD OF NURSING
TX783128OtherTEXAS BOARD OF NURSING