Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 305279 | NY |
Y | 363LG0600X | Nurse Practitioner - Gerontology | 340762 | NY |
NPI | 1073844262 |
---|---|
Provider Name | Jacqueline May Stewart-Hallett |
First Address | Philadelphia, PA 19138-1107 |
Second Address | New York, NY 10029-6508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2010 |
Last Update Date | 27/01/2010 |