Healthcare Provider Details

I. General information

NPI: 1164938882
Provider Name (Legal Business Name): KARIE E STEWART CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2017
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N GIANT CITY RD
CARBONDALE IL
62902-6418
US

IV. Provider business mailing address

1407 MCPHERSON AVE
MOUNT VERNON IL
62864-2822
US

V. Phone/Fax

Practice location:
  • Phone: 618-300-6017
  • Fax:
Mailing address:
  • Phone: 618-997-5266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number277002182
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number150120
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: