Provider Demographics
NPI:1922285261
Name:STEWART, RHONDA ELAINE (LPC, APRN)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:ELAINE
Last Name:STEWART
Suffix:
Gender:F
Credentials:LPC, APRN
Other - Prefix:DR
Other - First Name:RHONDA
Other - Middle Name:ELAINE
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, APRN
Mailing Address - Street 1:PO BOX 53
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:UT
Mailing Address - Zip Code:84647-0053
Mailing Address - Country:US
Mailing Address - Phone:435-262-0921
Mailing Address - Fax:
Practice Address - Street 1:255E 300N
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:UT
Practice Address - Zip Code:84634
Practice Address - Country:US
Practice Address - Phone:435-262-0921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT275220-6004101YM0800X
MT275220-4405363LP0808X
UT275220-4405363LP0808X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT275220-6004OtherUTAH STATE