Provider Demographics
NPI:1124421037
Name:STEWART, ELAINE L (ND)
Entity type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:L
Last Name:STEWART
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4518 N 39TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3602
Mailing Address - Country:US
Mailing Address - Phone:602-882-8923
Mailing Address - Fax:
Practice Address - Street 1:4518 N 39TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3602
Practice Address - Country:US
Practice Address - Phone:602-882-8923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14-1456175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath