Provider Demographics
NPI:1144067547
Name:STEWART, CALLIE CHRISTINE (SRNA)
Entity type:Individual
Prefix:MRS
First Name:CALLIE
Middle Name:CHRISTINE
Last Name:STEWART
Suffix:
Gender:F
Credentials:SRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 BRADFORD AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-4057
Mailing Address - Country:US
Mailing Address - Phone:843-737-3697
Mailing Address - Fax:
Practice Address - Street 1:151 RUTLEDGE AVE BLDG A
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-8903
Practice Address - Country:US
Practice Address - Phone:843-792-3328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program