Provider Demographics
NPI:1942466487
Name:STEWART, NATASHA ALEXANDRA (RN)
Entity Type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:ALEXANDRA
Last Name:STEWART
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:NATASHA
Other - Middle Name:ALEXANDRA
Other - Last Name:LORENZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:260 S KIPLING ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-1086
Mailing Address - Country:US
Mailing Address - Phone:303-239-7092
Mailing Address - Fax:303-239-7157
Practice Address - Street 1:260 S KIPLING ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-1086
Practice Address - Country:US
Practice Address - Phone:303-239-7092
Practice Address - Fax:303-239-7157
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO174104163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO16479254Medicaid