Individual
CAROLYN BLACKWELL STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
120
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP1174
—
SC
Enumeration date
07/12/2005
Last updated
08/17/2015
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