Courtney Stallworth, BSN RN IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

201879 Issued in TN

Practice address

113 S. Perry Street
Suite 206 #9313
Lawrenceville, GA 30046

Phone

(678) 712-8583

NPI assigned

Jan 15, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1417728684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 S. PERRY STREET",
            "address_2": "SUITE 206 #9313",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "678-712-8583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 S. PERRY STREET",
            "address_2": "SUITE 206 #9313",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "678-712-8583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLWORTH",
        "first_name": "COURTNEY",
        "credential": "BSN RN IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "TN",
            "license": "201879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda St. Phard
• Stable Care Services, Inc
• Jon E Stahlman, MD
• Shacresa D Staley, PHARM.D.
• Ioan Marius Stalinescu, PTA
• Devona M. Stalnaker-Shofner, LPC
• Anne Stambaugh, RN
• Jordan Mackenzie Stamper, NP
• Amanda Stamps, BCBA
• Cynthia Standard

• Lactation Consultant (Registered Nurse) in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Lactation Consultant (Registered Nurse) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.