Provider Demographics
NPI:1043974629
Name:STEWART, SHAKEYA
Entity Type:Individual
Prefix:
First Name:SHAKEYA
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 S NOVA RD APT 1506
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-5892
Mailing Address - Country:US
Mailing Address - Phone:914-987-9166
Mailing Address - Fax:
Practice Address - Street 1:1000 S NOVA RD APT 1506
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-5892
Practice Address - Country:US
Practice Address - Phone:914-987-9166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula