Individual
KORI DAWN STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1107 S ATKINSON AVE, ROSWELL, NM 88203-7154
(575) 578-4826
(575) 578-4828
Mailing address
1107 S ATKINSON AVE, ROSWELL, NM 88203-7154
(575) 578-4826
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
66740
NM
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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