Individual
SHANNON STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1360 S 5TH ST STE 200, SAINT CHARLES, MO 63301-2446
(314) 401-8802
Mailing address
1360 S 5TH ST STE 200, SAINT CHARLES, MO 63301-2446
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
LC001522117
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251E00000X
—
MO
Enumeration date
01/15/2018
Last updated
01/15/2018
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