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NPI Code Detail

MEDICARE: ERICA NICOLE STOCKWELL

MEDICARE:   ERICA NICOLE STOCKWELL
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
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962013334
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA NICOLE STOCKWELL
Provider Business Mailing Address
First Line : 3011 JOHN PAUL JONES CT APT D
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32221-2633
Country : US
Telephone Number : 707-816-7027
Fax Number :
Provider Business Practice Location Address
First Line : 7775 BAYMEADOWS WAY STE 200
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-7531
Country : US
Telephone Number : 216-612-6311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2020
Last Update Date : 09/11/2025

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Directions to “ ERICA NICOLE STOCKWELL ” Practice Location

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