Provider Demographics
NPI:1477009066
Name:STEWART, KRISTIN
Entity Type:Individual
Prefix:
First Name:KRISTIN
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 1:516 COOPER AVE
Mailing Address - Street 2:WALSH COUNTY SOCIAL SERVICES
Mailing Address - City:GRAFTON
Mailing Address - State:ND
Mailing Address - Zip Code:58237-1512
Mailing Address - Country:US
Mailing Address - Phone:701-352-5132
Mailing Address - Fax:701-352-5060
Practice Address - Street 1:516 COOPER AVE
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-1512
Practice Address - Country:US
Practice Address - Phone:701-352-5132
Practice Address - Fax:701-352-5060
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator