Stallworth, Demetrius

Stallworth, Demetrius is an individual health care provider with primary practice located at 490 Vineyard Ln , Orange Park FL 32073-7678. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Stallworth, Demetrius can be contacted via phone (904) 233-2008.

Contact Information

Primary practice address
490 Vineyard Ln Orange Park FL 32073-7678
Phone: (904) 233-2008
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X PN5192381 Florida

Profile Details

NPI number 1629506274
LBN Legal business name Stallworth, Demetrius
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2017
Last updated Jul 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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