Provider Demographics
NPI:1811585458
Name:STEWART, TOSHA ELIZABETH
Entity Type:Individual
Prefix:
First Name:TOSHA
Middle Name:ELIZABETH
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 1:121 PETTIS RD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3404
Mailing Address - Country:US
Mailing Address - Phone:907-570-1734
Mailing Address - Fax:
Practice Address - Street 1:121 PETTIS RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-3404
Practice Address - Country:US
Practice Address - Phone:907-570-1734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator