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General NPI Number Information
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NPI Number | 1144692997
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Entity Type | Individual
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Provider Name | PATRICIA M WORTLEY AUD
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Gender | Female
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 08/16/2016
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Provider Practice Location Address
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Address Line | 250 MCDAVID BLVD
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City | GRAYSON
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State | KY
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Zip | 41143-1603
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Country | US
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Telephone | 606-474-7835
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Fax |
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Provider Business Mailing Address
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Address Line | 12910 SHELBYVILLE RD SUITE 300
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City | LOUISVILLE
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State | KY
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Zip | 40243-1593
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Country | US
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Telephone | 502-244-2441
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Fax | 502-254-4069
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 148705
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | SLPAUD00193936
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License Number State | KY
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