Individual provider · Type 1 NPI

Demetrius Stallworth

Licensed Practical Nurse · Orange Park, FL

NPI number 1629506274 Active

Practice location

490 Vineyard Ln
Orange Park, FL 32073-7678

Call (904) 233-2008 Map

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000XPN5192381 (FL)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1629506274

Demetrius Stallworth's National Provider Identifier is 1629506274, issued on May 26, 2017. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Orange Park, FL. The record was last updated on Jul 21, 2022.