Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | ||
N | 176B00000X | Midwife | LM325 | CA |
Y | 176B00000X | Midwife | LMW-0082 | SC |
NPI | 1245520774 |
---|---|
Provider Name | Ms. Jennifer G Stewart |
First Address | Drayton, SC 29333-5030 |
Second Address | Greenville, SC 29609-4947 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2011 |
Last Update Date | 17/03/2020 |