Organization
WAYFARER WELLNESS CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILLIAN AUDREYA FAWN STUPER DNP, MSN, FNP-C (OWNER/NURSE PRACTITIONER)
(727) 777-9355
Entity
Organization
Contact information
Practice address
6322 ROWAN RD, NEW PORT RICHEY, FL 34653-3400
(727) 777-9355
(800) 339-7093
Mailing address
6322 ROWAN RD, NEW PORT RICHEY, FL 34653-3400
(727) 777-9355
(800) 339-7093
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043718521
NPI
FL
01
—
9344892
STATE LICENSE
FL
Enumeration date
06/16/2026
Last updated
07/04/2026
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