Provider Demographics
NPI:1811509912
Name:STEWART, STEVEN DON-ROBERT (LVN)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:DON-ROBERT
Last Name:STEWART
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-2943
Mailing Address - Country:US
Mailing Address - Phone:865-318-1891
Mailing Address - Fax:
Practice Address - Street 1:512 OAKWOOD DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2943
Practice Address - Country:US
Practice Address - Phone:865-318-1891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN84367164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse