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General NPI Number Information
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NPI Number | 1205132081
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Entity Type | Individual
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Provider Name | KATHERINE ANN WORTHINGTON PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/27/2011
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Last Update Date | 09/04/2011
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Provider Practice Location Address
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Address Line | 2500 ENGLISH CREEK AVE BLDG 800
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City | EGG HARBOR TWP
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State | NJ
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Zip | 08234-5549
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Country | US
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Telephone | 800-321-9999
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Fax | 609-677-6061
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Provider Business Mailing Address
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Address Line | 2500 ENGLISH CREEK AVE BLDG 800
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City | EGG HARBOR TWP
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State | NJ
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Zip | 08234-5549
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Country | US
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Telephone | 800-321-9999
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Fax | 609-677-6061
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA054007
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 25MP00264300
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License Number State | NJ
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