Individual
STACIE DEE O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
630 ROBERTS RD, JACKSONVILLE, FL 32259-8915
(952) 201-5375
Mailing address
630 ROBERTS RD, JACKSONVILLE, FL 32259-8915
(952) 201-5375
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9551683
FL
183500000X
Pharmacist
PSI43685
FL
Other
Enumeration date
09/22/2025
Last updated
09/22/2025
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