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Individual

DEBORAH ANN STALLWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
821 E UPSAL ST, PHILADELPHIA, PA 19119-1542
(215) 764-9679
Mailing address
821 E UPSAL ST, PHILADELPHIA, PA 19119-1542
(215) 844-4278

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP013407
PA

Other

Enumeration date
04/07/2016
Last updated
04/07/2016
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