MEDICARE: KAREN P 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
1	1041C0700X	Clinical Social Worker	M0518	MS

General Provider Information

NPI Number	:	1487087607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN P STEWART

Provider Business Mailing Address
First Line	:	2624 SOUTHERLAND ST
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39216-4825
Country	:	US
Telephone Number	:	601-266-4282
Fax Number	:	601-366-4287

Provider Business Practice Location Address
First Line	:	2624 SOUTHERLAND ST
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39216-4825
Country	:	US
Telephone Number	:	601-266-4282
Fax Number	:	601-366-4287

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2013
Last Update Date	:	08/12/2013

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Directions to “ KAREN P STEWART ” Practice Location

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