Provider Demographics
NPI:1508190372
Name:STEWART, MONICA (RN, BSN)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6620 ROCKGLEN WAY
Mailing Address - Street 2:NUMBER 615
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615
Mailing Address - Country:US
Mailing Address - Phone:919-539-7973
Mailing Address - Fax:919-954-7098
Practice Address - Street 1:6620 ROCKGLEN WAY
Practice Address - Street 2:NUMBER 615
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5600
Practice Address - Country:US
Practice Address - Phone:919-539-7973
Practice Address - Fax:919-954-7098
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC226487163W00000X, 163WC1500X, 163WC1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development