Individual
MRS. CANDICE SHERESE STALLWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, PMHNP-BC
Contact information
Practice address
2301 MEDPARK DR, ROCKY MOUNT, NC 27804-2288
(252) 962-5410
Mailing address
2301 MEDPARK DR, ROCKY MOUNT, NC 27804-2288
(252) 962-5410
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
232478
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5013060
NC
Other
Enumeration date
02/19/2020
Last updated
02/05/2025
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