Basic Information
| Provider Information | |||||||||
| NPI: | 1588186399 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAMARI STEWART | ||||||||
| FirstName: | EMILY | ||||||||
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| Credential: | APRN, NNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4533 WILDERNESS PASS | ||||||||
| Address2: | |||||||||
| City: | KELLER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762629123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2149087279 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1301 PENNSYLVANIA AVE | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761042122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8172502892 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2017 | ||||||||
| LastUpdateDate: | 03/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LN0005X | AP134656 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Neonatal, Critical Care | 363LN0000X | AP134656 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Neonatal | 163WN0002X | 798305 | TX | N | Nursing Service Providers | Registered Nurse | Neonatal Intensive Care |
No ID Information.