Provider Demographics
NPI:1992158802
Name:STEWART, KIERRA (RN)
Entity type:Individual
Prefix:MS
First Name:KIERRA
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25678 PALMWOOD CT
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-6598
Mailing Address - Country:US
Mailing Address - Phone:225-308-4553
Mailing Address - Fax:225-208-7005
Practice Address - Street 1:25678 PALMWOOD CT
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-6598
Practice Address - Country:US
Practice Address - Phone:225-308-4553
Practice Address - Fax:225-208-7005
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA147991163WP0807X, 163WS0200X, 163W00000X, 163WA2000X, 163WC0400X, 163WH0200X, 163WC1600X, 163WG0600X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WS0200XNursing Service ProvidersRegistered NurseSchool
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WG0600XNursing Service ProvidersRegistered NurseGerontology