Provider Demographics
NPI:1558861435
Name:STEWART, CATHRYN ANN
Entity Type:Individual
Prefix:
First Name:CATHRYN
Middle Name:ANN
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 1:600 WOODBRIDGE PKWY APT 3118
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-7043
Mailing Address - Country:US
Mailing Address - Phone:972-802-2575
Mailing Address - Fax:
Practice Address - Street 1:600 WOODBRIDGE PKWY APT 3118
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-7043
Practice Address - Country:US
Practice Address - Phone:972-802-2575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant