Provider Demographics
NPI:1891058525
Name:STEWARD, CYNTHIA L (RN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:STEWARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1097 E 575 N
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84040-3648
Mailing Address - Country:US
Mailing Address - Phone:801-546-2533
Mailing Address - Fax:
Practice Address - Street 1:982 CHAMBERS ST
Practice Address - Street 2:
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-4571
Practice Address - Country:US
Practice Address - Phone:801-479-4105
Practice Address - Fax:801-584-2590
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT210420-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse