Provider Demographics
NPI:1164883716
Name:STEWART, EMILY (MPH, RDN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5512 61ST LN E STE 600
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-9758
Mailing Address - Country:US
Mailing Address - Phone:717-817-3293
Mailing Address - Fax:
Practice Address - Street 1:5337 PAYLOR LN STE 600
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34240-2212
Practice Address - Country:US
Practice Address - Phone:609-436-5306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-10
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
FLND10249133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered