Provider Demographics
NPI:1205609492
Name:STALLWORTH, RION (RN)
Entity type:Individual
Prefix:
First Name:RION
Middle Name:
Last Name:STALLWORTH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W 4TH ST APT 1212
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-2581
Mailing Address - Country:US
Mailing Address - Phone:980-900-8692
Mailing Address - Fax:
Practice Address - Street 1:205 W 4TH ST APT 1212
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-2581
Practice Address - Country:US
Practice Address - Phone:980-900-8692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC341829163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse