Mariah Anne Stewart

Individual provider Active NPI Athletic Trainer · Prescott, WI

NPI 1790259554 · NPPES record last updated Jan 15, 2019

Key facts

NPI
1790259554
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
N6382 1297TH St
Prescott, WI 54021-7034
Phone
(715) 441-8598
NPI assigned
Jan 15, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer
Group: 193400000X SINGLE SPECIALTY GROUP
2255A2300X Yes

Addresses

Primary practice location

N6382 1297TH St
Prescott, WI 54021-7034

Mailing address

N6382 1297TH St
Prescott, WI 54021-7034
Phone (715) 441-8598

Other providers in Prescott, WI

All providers in Prescott, WI · Athletic Trainer in Wisconsin

Sources for this page

Verify at the official NPI Registry.