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General NPI Number Information
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NPI Number | 1386946853
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Entity Type | Individual
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Provider Name | KARA MICHELE WORTLEY P.A.
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Gender | Female
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Dates
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Enumeration Date | 12/03/2010
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 1145 STURGIS ROAD NAVAL HOSPITAL TWENTYNINE PALMS
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City | TWENTYNINE PALMS
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State | CA
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Zip | 92278-1831
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Country | US
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Telephone | 760-830-2617
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 788250
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City | TWENTYNINE PALMS
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State | CA
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Zip | 92278-8250
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Country | US
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Telephone | 760-830-2617
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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