MEDICARE: KEINA BRYANT WORRELL

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
1	171100000X	Acupuncturist	AP4737	FL

General Provider Information

NPI Number	:	1396676425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEINA BRYANT WORRELL

Provider Business Mailing Address
First Line	:	4760 CUMBERLAND COVE CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-5294
Country	:	US
Telephone Number	:	904-339-5068
Fax Number	:

Provider Business Practice Location Address
First Line	:	4741 ATLANTIC BLVD STE E2
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-1138
Country	:	US
Telephone Number	:	904-339-5068
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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Directions to “ KEINA BRYANT WORRELL ” Practice Location

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