Individual
TIFFANY MARIE STOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
580 W 8TH ST, JACKSONVILLE, FL 32209-6533
(904) 244-9289
Mailing address
192 N LAKE CUNNINGHAM AVE, SAINT JOHNS, FL 32259-7938
(386) 214-2550
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
11014976
FL
363LA2100X
Acute Care Nurse Practitioner
Primary
11014976
FL
363LA2200X
Adult Health Nurse Practitioner
11014976
FL
363LG0600X
Gerontology Nurse Practitioner
11014976
FL
Other
Enumeration date
09/16/2022
Last updated
09/22/2022
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