Individual
THERESA L STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF PSYCHIATRY, SHREVEPORT, LA 71103-4228
(318) 813-2445
(318) 813-2447
Mailing address
1501 KINGS HWY, DEPARTMENT OF PSYCHIATRY, SHREVEPORT, LA 71103-4228
(318) 813-2445
(318) 813-2447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN061158
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1108901
—
LA
Enumeration date
07/17/2006
Last updated
08/20/2009
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