Provider Demographics
NPI:1659349488
Name:STEWART, NICOLE V (MA, MS)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:V
Last Name:STEWART
Suffix:
Gender:F
Credentials:MA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 ROSEDALE AVE
Mailing Address - Street 2:APT#214
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3752
Mailing Address - Country:US
Mailing Address - Phone:301-951-0488
Mailing Address - Fax:
Practice Address - Street 1:NATIONAL NAVAL MEDICAL CENTER - 8901 WISCONSIN AVE
Practice Address - Street 2:BEHAVIORAL HEALTHCARE CLINIC - BLDG 7, 3RD FLOOR
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-295-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program