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General NPI Number Information
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NPI Number | 1134738305
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Entity Type | Individual
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Provider Name | MARLA WORLEY
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Gender | Female
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Dates
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Enumeration Date | 07/23/2020
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Last Update Date | 07/23/2020
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Provider Practice Location Address
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Address Line | 1103 W PROSPECT RD
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City | FORT COLLINS
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State | CO
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Zip | 80526-5664
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Country | US
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Telephone | 970-221-3073
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Fax |
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Provider Business Mailing Address
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Address Line | 2131 GRAIN BIN DR
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City | WINDSOR
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State | CO
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Zip | 80550-3426
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Country | US
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Telephone | 970-218-0785
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0011513
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License Number State | CO
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