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Individual
THOMAS STALLWORTH
Active
Individual
THOMAS STALLWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1-114845
AL
363LP0200X
Pediatric Nurse Practitioner
902668
MS
363LP0200X
Pediatric Nurse Practitioner
9331690
FL
Other
Enumeration date
03/31/2014
Last updated
10/19/2021
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