Healthcare Provider Details

I. General information

NPI: 1033430558
Provider Name (Legal Business Name): MICHELLE ANN STEWART RN., CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2010
Last Update Date: 06/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 LOWER PINEY CREEK RD
WILLIAMSBURG PA
16693-8412
US

IV. Provider business mailing address

106 LOWER PINEY CREEK RD
WILLIAMSBURG PA
16693-8412
US

V. Phone/Fax

Practice location:
  • Phone: 814-832-2225
  • Fax: 814-832-1005
Mailing address:
  • Phone: 814-832-2225
  • Fax: 814-832-1005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN529254L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN529254L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number04090013
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: