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Individual

LATARSHA STEWART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1315 BEATTIES FORD RD, CHARLOTTE, NC 28216-5037
(386) 212-4815
Mailing address
1315 BEATTIES FORD RD, CHARLOTTE, NC 28216-5037
(386) 212-4815

Taxonomy

Speciality
Code
Description
License number
State
372500000X
Chore Provider
NC
374U00000X
Home Health Aide
Primary
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
S363-538-73-562-0
NC
Enumeration date
09/07/2022
Last updated
09/08/2022
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