Provider Demographics
NPI:1376307256
Name:STEWART, AMY K (RN, BSN, IBCLC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:K
Last Name:STEWART
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9958 BRITTAINS WAY
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46158-7168
Mailing Address - Country:US
Mailing Address - Phone:317-698-8542
Mailing Address - Fax:
Practice Address - Street 1:9958 BRITTAINS WAY
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-7168
Practice Address - Country:US
Practice Address - Phone:317-698-8542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28135802A163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant