Healthcare Provider Details

I. General information

NPI: 1255130001
Provider Name (Legal Business Name): MRS. KIRBY STEWART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS KIRBY REEVES

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7666 BRIARMEADOW LN
COLUMBUS OH
43235-1619
US

IV. Provider business mailing address

7666 BRIARMEADOW LN
COLUMBUS OH
43235-1619
US

V. Phone/Fax

Practice location:
  • Phone: 614-325-1718
  • Fax:
Mailing address:
  • Phone: 614-325-1718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: