Provider Demographics
NPI:1609528991
Name:STEWART, TAMARA PATRICE
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:PATRICE
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 1:8588 SUNLIGHT DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-4164
Mailing Address - Country:US
Mailing Address - Phone:513-473-6041
Mailing Address - Fax:
Practice Address - Street 1:8144 MONON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45216-1418
Practice Address - Country:US
Practice Address - Phone:513-488-0568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSQ163987251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health