Individual
DANIEL PATRICK STUART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP-BC
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-1627
Mailing address
2500 N STATE STREET, JACKSON, MS 39216-4500
(601) 984-5500
(601) 984-5503
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R858532
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07457849
—
MS
05
—
192809
—
AL
01
—
302I508607
MEDICARE PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
MS
01
—
P01402432
RR MEDICARE
MS
Enumeration date
11/19/2008
Last updated
12/12/2016
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