Individual
MRS. STEPHANIE C WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1689 EAGLE HARBOR PKWY E, SUITE A, ORANGE PARK, FL 32003-4817
(904) 269-1366
(904) 264-9750
Mailing address
705 WELLS RD STE 300, ORANGE PARK, FL 32073-2982
(904) 282-6331
(904) 619-1080
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
06/15/2009
Last updated
09/16/2022
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