Individual
MRS. STACEY DILWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
200 N HIGHWAY 25, TRAVELERS REST, SC 29690-2300
(866) 389-2727
Mailing address
109 CALLAHAN AVE, GREENVILLE, SC 29617-2416
(864) 918-9705
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20307
SC
Other
Enumeration date
07/05/2016
Last updated
07/05/2016
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