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General NPI Number Information
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NPI Number | 1023428638
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Entity Type | Individual
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Provider Name | JODY STEWART
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Gender | Female
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 05/05/2014
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Provider Practice Location Address
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Address Line | 140 S. MAIN STREET EDISON LOCAL SCHOOL DISTRICT
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City | MILAN
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State | OH
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Zip | 44846
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Country | US
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Telephone | 419-499-4652
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Fax |
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Provider Business Mailing Address
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Address Line | 140 S. MAIN STREET EDISON LOCAL SCHOOL DISTRICT
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City | MILAN
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State | OH
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Zip | 44846
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | RN215003
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License Number State | WV
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