Provider Demographics
NPI:1255752598
Name:STEWART, BRIGITTE
Entity type:Individual
Prefix:MRS
First Name:BRIGITTE
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 S 6 STREET
Mailing Address - Street 2:
Mailing Address - City:LOVING
Mailing Address - State:NM
Mailing Address - Zip Code:88256
Mailing Address - Country:US
Mailing Address - Phone:575-745-2077
Mailing Address - Fax:575-745-2072
Practice Address - Street 1:602 S 6 STREET
Practice Address - Street 2:
Practice Address - City:LOVING
Practice Address - State:NM
Practice Address - Zip Code:88256
Practice Address - Country:US
Practice Address - Phone:575-745-2077
Practice Address - Fax:575-745-2072
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR32191163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool