Provider Demographics
NPI:1578297362
Name:STEWARD, JACQUELINE DENISE
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:DENISE
Last Name:STEWARD
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 1:43 ELDRED AVE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2637
Mailing Address - Country:US
Mailing Address - Phone:216-926-4721
Mailing Address - Fax:
Practice Address - Street 1:43 ELDRED AVE
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-2637
Practice Address - Country:US
Practice Address - Phone:216-926-4721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care