Healthcare Provider Details

I. General information

NPI: 1285598938
Provider Name (Legal Business Name): ANNA NICOLE STEWART RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA NICOLE SMITH RRT

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2729 MEADOWBROOK DR
BURLINGTON IA
52601-1620
US

IV. Provider business mailing address

2729 MEADOWBROOK DR
BURLINGTON IA
52601-1620
US

V. Phone/Fax

Practice location:
  • Phone: 319-750-8851
  • Fax:
Mailing address:
  • Phone: 319-750-8851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number097189
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: