Basic Information
Provider Information
NPI: 1780881532
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NARUKO-STEWART
FirstName: KIMBERLY
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6405 FRANCE AVE S
Address2: SUITE W400
City: EDINA
State: MN
PostalCode: 554352163
CountryCode: US
TelephoneNumber: 9529202730
FaxNumber: 9525677090
Practice Location
Address1: 6405 FRANCE AVE S
Address2: SUITE W400
City: EDINA
State: MN
PostalCode: 554352163
CountryCode: US
TelephoneNumber: 9529202730
FaxNumber: 9525677090
Other Information
ProviderEnumerationDate: 06/27/2007
LastUpdateDate: 01/04/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X53954MNY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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