Provider Demographics
NPI:1427282367
Name:STEWART, BRENDA KAY (WHNP)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:KAY
Last Name:STEWART
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:MRS
Other - First Name:BRENDA
Other - Middle Name:F
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:657 HELEN KELLER BLVD
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-2983
Mailing Address - Country:US
Mailing Address - Phone:205-799-5848
Mailing Address - Fax:205-344-9031
Practice Address - Street 1:2731 MLK JR BLVD
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-5235
Practice Address - Country:US
Practice Address - Phone:205-349-3250
Practice Address - Fax:205-345-3993
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR882358363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL164793Medicaid