Individual
MARY BETH STUART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
15319 W 95TH ST, LENEXA, KS 66219-1262
(913) 495-9905
Mailing address
15319 W 95TH ST, LENEXA, KS 66219-1262
(913) 495-9905
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
007373
NY
363A00000X
Physician Assistant
Primary
15-01673
KS
363A00000X
Physician Assistant
2014005142
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02730032
—
NY
Enumeration date
07/31/2006
Last updated
01/12/2015
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