Provider Demographics
NPI:1235657909
Name:STEWART, SHAUNTEL
Entity Type:Individual
Prefix:
First Name:SHAUNTEL
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 1:4439 READING RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-1207
Mailing Address - Country:US
Mailing Address - Phone:513-996-0037
Mailing Address - Fax:513-996-0047
Practice Address - Street 1:4439 READING RD STE 101
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229
Practice Address - Country:US
Practice Address - Phone:513-996-0037
Practice Address - Fax:513-996-0047
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2019-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No376K00000XNursing Service Related ProvidersNurse's Aide