Individual
MRS. TESSIE MARI STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3015 E MAGIC VIEW DR # 115, MERIDIAN, ID 83642-3743
(208) 321-4000
Mailing address
2401 N 36TH ST, BOISE, ID 83703-5209
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/29/2019
Last updated
12/11/2021
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