Provider Demographics
NPI:1629684782
Name:STEWARD, GABRIELLE (CBD, CPD)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:STEWARD
Suffix:
Gender:F
Credentials:CBD, CPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 SCARLETT LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-5888
Mailing Address - Country:US
Mailing Address - Phone:912-271-5488
Mailing Address - Fax:
Practice Address - Street 1:99 SCARLETT LN
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-5888
Practice Address - Country:US
Practice Address - Phone:912-271-5488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty