Provider Demographics
NPI:1851775332
Name:STEWART, ASHLEY M (CLC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:STEWART
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7065 MARROWBONE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ELKHORN CITY
Mailing Address - State:KY
Mailing Address - Zip Code:41522-7525
Mailing Address - Country:US
Mailing Address - Phone:606-471-4296
Mailing Address - Fax:
Practice Address - Street 1:7065 MARROWBONE CREEK RD
Practice Address - Street 2:
Practice Address - City:ELKHORN CITY
Practice Address - State:KY
Practice Address - Zip Code:41522-7525
Practice Address - Country:US
Practice Address - Phone:606-471-4296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
1OtherNO OTHER ISSUER