Provider Demographics
NPI:1295967198
Name:STEWART, NOELLE JONES (RD)
Entity type:Individual
Prefix:MRS
First Name:NOELLE
Middle Name:JONES
Last Name:STEWART
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 AVENUE D
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-4961
Mailing Address - Country:US
Mailing Address - Phone:678-462-8604
Mailing Address - Fax:
Practice Address - Street 1:1171 GATEWOOD DR BLDG 101
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-1828
Practice Address - Country:US
Practice Address - Phone:678-462-8604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1737133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered