Individual
CARISSA BONANY STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4745 MARIGOLD RD, MENTOR, OH 44060-1135
(440) 227-2295
Mailing address
33001 VINE ST APT E9, WILLOWICK, OH 44095-3359
(440) 223-3432
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.152364.MEDS-IV
OH
Other
Enumeration date
06/18/2017
Last updated
07/21/2022
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