Provider Demographics
NPI:1164542304
Name:STEWART, KAREN ALIDA (RD)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ALIDA
Last Name:STEWART
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2092 MISSION DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-7107
Mailing Address - Country:US
Mailing Address - Phone:239-566-7916
Mailing Address - Fax:
Practice Address - Street 1:399 9TH STREET NORTH
Practice Address - Street 2:SUITE 201
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102
Practice Address - Country:US
Practice Address - Phone:239-436-4861
Practice Address - Fax:239-436-6879
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1773133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered