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NPI Code Detail

MEDICARE: MRS. TRIKENYA UWANA PAUL-STALLWORTH APRN PMHNP

MEDICARE: MRS. TRIKENYA UWANA PAUL-STALLWORTH APRN PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN11029224FL

General Provider Information

NPI Number : 1295508224
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TRIKENYA UWANA PAUL-STALLWORTH APRN PMHNP
Provider Business Mailing Address
First Line : 2252 KILLEARN CENTER BLVD STE 300
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32309-3573
Country : US
Telephone Number : 239-690-6906
Fax Number :
Provider Business Practice Location Address
First Line : 2252 KILLEARN CENTER BLVD STE 300
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32309-3573
Country : US
Telephone Number : 239-690-6906
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2023
Last Update Date : 08/18/2025

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