Provider Demographics
NPI:1497874176
Name:HARDWICK-STEWART, CHERYL A
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:A
Last Name:HARDWICK-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 1:10309 ROSEHILL AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44104-3640
Mailing Address - Country:US
Mailing Address - Phone:216-355-5391
Mailing Address - Fax:800-662-9647
Practice Address - Street 1:10309 ROSEHILL AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104-3640
Practice Address - Country:US
Practice Address - Phone:216-752-1305
Practice Address - Fax:216-355-5391
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN093524164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2243969Medicaid