Healthcare Provider Details

I. General information

NPI: 1659206498
Provider Name (Legal Business Name): AMANDA E STEWART CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 1/2 N BROAD ST
MONROE GA
30655-1886
US

IV. Provider business mailing address

1500 BRUSHCREEK DR
MONROE GA
30655-3700
US

V. Phone/Fax

Practice location:
  • Phone: 678-982-2549
  • Fax: 706-413-2098
Mailing address:
  • Phone: 678-982-2549
  • Fax: 706-413-2098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: