Individual
CANDICE JOY STEPHENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
836 PRUDENTIAL DR, SUITE 1601, JACKSONVILLE, FL 32207-8334
(904) 396-8060
(904) 396-9700
Mailing address
PO BOX 41516, JACKSONVILLE, FL 32203-1516
(904) 202-5111
(904) 396-9700
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9108303
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014983500
—
FL
01
—
P01498314
RAILROAD MEDICARE
FL
Enumeration date
05/11/2015
Last updated
11/17/2015
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