Individual
SHANNON ELYSE STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9556 MANCHESTER RD, SAINT LOUIS, MO 63119-1313
(314) 961-2255
Mailing address
38 SNOWMASS CT, O FALLON, MO 63368-6677
(636) 293-2634
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2020028541
MO
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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