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NPI Code Detail

MEDICARE: AMBROSIA STEWART

MEDICARE:   AMBROSIA  STEWART
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1073122784
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBROSIA STEWART
Provider Business Mailing Address
First Line : 2419 PALORA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-2156
Country : US
Telephone Number : 702-704-9136
Fax Number : 702-633-5895
Provider Business Practice Location Address
First Line : 2419 PALORA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-2156
Country : US
Telephone Number : 702-704-9136
Fax Number : 702-633-5895
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2020
Last Update Date : 07/28/2020

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Directions to “ AMBROSIA STEWART ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.