Individual
JERL DAVID STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1000 SAINT JOSEPH LANE, LONDON, KY 40741-8345
(606) 330-6000
(606) 330-7825
Mailing address
100 E LIBERTY ST, SUITE 800, LOUISVILLE, KY 40202-1434
(606) 330-6000
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3006450
KY
367500000X
Certified Registered Nurse Anesthetist
R82527
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177959001
—
AR
05
—
7100103680
—
KY
Enumeration date
03/12/2009
Last updated
11/07/2014
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