THERESA DENISE STEWART NPI 1619483351

NPI Information

NPI: 1619483351
Provider Name: THERESA DENISE STEWART
Classification: Licensed Practical Nurse - 164W00000X
Entity Type: Individual
Address:
300 N HURON ST STE 10
YPSILANTI, MI
ZIP 48197
Phone: (734) 480-0125
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Theresa Denise Stewart is a licensed practical nurse in Ypsilanti, MI. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. Theresa Denise Stewart NPI is 1619483351. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

300 N HURON ST STE 10
YPSILANTI, MI
ZIP 48197-842
Phone: (734) 480-0125
Fax: (734) 480-0125

The enumeration date for this NPI number is 12/18/2017 and was last updated on 12/18/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	164W00000X	Licensed Practical Nurse		4703087489	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1629279732	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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