Individual
DR. BENJAMIN RUSSEL STUART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP, APRN, FNP-C
Contact information
Practice address
330 S CHILOQUIN BLVD, CHILOQUIN, OR 97624-6747
(541) 882-1487
Mailing address
2353 E 3225 S, SALT LAKE CITY, UT 84109-2719
(435) 881-4809
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
5942204-3102
UT
163W00000X
Registered Nurse
95035396
CA
363LF0000X
Family Nurse Practitioner
Primary
5942204-4405
UT
Other
Enumeration date
07/06/2017
Last updated
07/21/2022
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