Provider Demographics
NPI:1861734972
Name:STEWART, BOBBY JEAN (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:BOBBY
Middle Name:JEAN
Last Name:STEWART
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8094 CHRYSALIS CV
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-7197
Mailing Address - Country:US
Mailing Address - Phone:901-791-2478
Mailing Address - Fax:
Practice Address - Street 1:670 N GERMANTOWN PKWY STE 18
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-6287
Practice Address - Country:US
Practice Address - Phone:901-753-7686
Practice Address - Fax:901-759-9968
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017778363L00000X
MS903352363LF0000X
TN17459363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner