Individual
MRS. CONSTANCE STITT FAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3968 HUNTERS LAKE CIR W, JACKSONVILLE, FL 32210-4667
(904) 779-2355
Mailing address
3968 HUNTERS LAKE CIR W, JACKSONVILLE, FL 32210-4667
(904) 704-0679
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
682598296
—
FL
05
—
682598298
—
FL
Enumeration date
03/28/2011
Last updated
03/28/2011
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