Provider Demographics
NPI:1730866815
Name:STEWART, NATALIE CARA (RN, NBC-HWC)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:CARA
Last Name:STEWART
Suffix:
Gender:F
Credentials:RN, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2882
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:WY
Mailing Address - Zip Code:83128-2610
Mailing Address - Country:US
Mailing Address - Phone:307-413-5541
Mailing Address - Fax:
Practice Address - Street 1:625 E BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:WY
Practice Address - Zip Code:83001-8642
Practice Address - Country:US
Practice Address - Phone:307-739-7244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY17539163W00000X
171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No163W00000XNursing Service ProvidersRegistered Nurse