Provider Demographics
NPI:1952679920
Name:STEWART, ANITA ANN (STNA)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:ANN
Last Name:STEWART
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1763 BIDE A WEE PARK AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-3040
Mailing Address - Country:US
Mailing Address - Phone:614-252-6218
Mailing Address - Fax:
Practice Address - Street 1:1763 BIDE A WEE PARK AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-3040
Practice Address - Country:US
Practice Address - Phone:614-252-6218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH371739670600376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide