Provider Demographics
NPI:1932244357
Name:STEWART, NIKA SHANNON (CRNA)
Entity Type:Individual
Prefix:
First Name:NIKA
Middle Name:SHANNON
Last Name:STEWART
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:NIKA
Other - Middle Name:SHANNON
Other - Last Name:GRAMMAS, JANOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:801 E 6TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-3652
Mailing Address - Country:US
Mailing Address - Phone:850-785-3185
Mailing Address - Fax:
Practice Address - Street 1:801 E 6TH ST STE 202
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3652
Practice Address - Country:US
Practice Address - Phone:850-785-3185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLARNP2856672367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered