MEDICARE: KATELYN STEWART

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1891577037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN STEWART

Provider Business Mailing Address
First Line	:	9735 MOUNT CARMEL RD
Second Line	:
City	:	BRIGHTON
State	:	TN
Zip	:	38011-6913
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9735 MOUNT CARMEL RD
Second Line	:
City	:	BRIGHTON
State	:	TN
Zip	:	38011-6913
Country	:	US
Telephone Number	:	901-832-6414
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2023
Last Update Date	:	10/20/2023

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Directions to “ KATELYN STEWART ” Practice Location

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