Provider Demographics
NPI:1336925973
Name:STEWART, CODY JAMES (BSN, RN)
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:JAMES
Last Name:STEWART
Suffix:
Gender:M
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 COUNTY ROAD 461
Mailing Address - Street 2:
Mailing Address - City:HANCEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35077-8111
Mailing Address - Country:US
Mailing Address - Phone:256-962-8055
Mailing Address - Fax:
Practice Address - Street 1:340 COUNTY ROAD 461
Practice Address - Street 2:
Practice Address - City:HANCEVILLE
Practice Address - State:AL
Practice Address - Zip Code:35077-8111
Practice Address - Country:US
Practice Address - Phone:256-962-8055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-181229163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse