Provider Demographics
NPI:1932708849
Name:STEWART, DONNA MARIE
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
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 1:2658 SPILLMAN LN
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:WV
Mailing Address - Zip Code:25287-8821
Mailing Address - Country:US
Mailing Address - Phone:304-857-8716
Mailing Address - Fax:
Practice Address - Street 1:2658 SPILLMAN LN
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:WV
Practice Address - Zip Code:25287-8821
Practice Address - Country:US
Practice Address - Phone:304-857-8716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant