Provider Demographics
NPI:1316454754
Name:STEWARD, BRYNN MARIE (CRNA)
Entity type:Individual
Prefix:
First Name:BRYNN
Middle Name:MARIE
Last Name:STEWARD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:BRYNN
Other - Middle Name:
Other - Last Name:WALLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:542 BEDFORD FALLS LN
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-8428
Mailing Address - Country:US
Mailing Address - Phone:214-668-9971
Mailing Address - Fax:
Practice Address - Street 1:4215 JOE RAMSEY BLVD E
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-7852
Practice Address - Country:US
Practice Address - Phone:903-408-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-08
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119873367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX839287OtherTEXAS BOARD OF NURSING
TX119873OtherNATIONAL BOARD OF CERTIFICATION AND RECERTIFICATION FOR NURSE ANESTHETISTS