Individual
DIANE STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21 PEORIA LN, SICKLERVILLE, NJ 08081-1816
(856) 875-5325
Mailing address
21 PEORIA LN, SICKLERVILLE, NJ 08081-1816
(856) 875-5325
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
SP014790
PA
Other
Enumeration date
02/16/2015
Last updated
02/16/2015
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