Healthcare Provider Details

I. General information

NPI: 1336844000
Provider Name (Legal Business Name): AYANA NACHEYL STEWART CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 TAYLOR RD
MONTGOMERY AL
36117-3512
US

IV. Provider business mailing address

673 ABERDEEN CIR
GROVETOWN GA
30813-5989
US

V. Phone/Fax

Practice location:
  • Phone: 334-747-2991
  • Fax:
Mailing address:
  • Phone: 443-686-1046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1227753
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN270825
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4020865
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3-002829
License Number StateAL
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN270825
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: