Provider Demographics
NPI:1912559360
Name:STEWART, MARCEE (FNP)
Entity type:Individual
Prefix:
First Name:MARCEE
Middle Name:
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 1:1770 PACKSADDLE RD
Mailing Address - Street 2:
Mailing Address - City:WALDRON
Mailing Address - State:AR
Mailing Address - Zip Code:72958-7231
Mailing Address - Country:US
Mailing Address - Phone:479-310-6402
Mailing Address - Fax:
Practice Address - Street 1:1770 PACKSADDLE RD
Practice Address - Street 2:
Practice Address - City:WALDRON
Practice Address - State:AR
Practice Address - Zip Code:72958-7231
Practice Address - Country:US
Practice Address - Phone:479-310-6402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-15
Last Update Date:2025-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM63629363LF0000X
AR227761363LF0000X
OR201905669NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1713802Medicaid