Healthcare Provider Details

I. General information

NPI: 1396139812
Provider Name (Legal Business Name): LEAH J STEWART
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2015
Last Update Date: 03/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 E JAMES CAMPBELL BLVD SUITE 113
COLUMBIA TN
38401-4597
US

IV. Provider business mailing address

230 E JAMES CAMPBELL BLVD SUITE 113
COLUMBIA TN
38401-4597
US

V. Phone/Fax

Practice location:
  • Phone: 931-490-1580
  • Fax: 931-490-1506
Mailing address:
  • Phone: 931-490-1580
  • Fax: 931-490-1506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: