Provider Demographics
NPI:1912792607
Name:STEWART, SHEA E (CNM)
Entity type:Individual
Prefix:
First Name:SHEA
Middle Name:E
Last Name:STEWART
Suffix:
Gender:
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 CAPTAIN DEXTER WYND
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-8363
Mailing Address - Country:US
Mailing Address - Phone:910-269-1089
Mailing Address - Fax:
Practice Address - Street 1:512 CAPTAIN DEXTER WYND
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-8363
Practice Address - Country:US
Practice Address - Phone:910-269-1089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife