Individual
MS. EQUILLA KATRICE STALLWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6639 SOUTHPOINT PKWY STE 108, JACKSONVILLE, FL 32216-8042
(904) 438-7640
(904) 438-7656
Mailing address
3307 CHESTNUT RIDGE WAY, ORANGE PARK, FL 32065-3635
(904) 438-7640
(904) 438-7656
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5248091
FL
Other
Enumeration date
03/24/2026
Last updated
03/24/2026
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