Provider Demographics
NPI:1457680167
Name:STEWART, ANN DELISHA (ASN)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:DELISHA
Last Name:STEWART
Suffix:
Gender:F
Credentials:ASN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5682 EDDINS RD
Mailing Address - Street 2:APT E
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3671
Mailing Address - Country:US
Mailing Address - Phone:334-207-5047
Mailing Address - Fax:
Practice Address - Street 1:5682 EDDINS RD
Practice Address - Street 2:APT E
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3671
Practice Address - Country:US
Practice Address - Phone:334-207-5047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-124184163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse