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General NPI Number Information
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NPI Number | 1780679589
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Entity Type | Individual
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Provider Name | NANCY M WORTHINGTON MD
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Gender | Female
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Dates
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Enumeration Date | 09/18/2005
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 1600 SW ARCHER RD
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City | GAINESVILLE
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State | FL
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Zip | 32610-3003
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Country | US
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Telephone | 352-371-3604
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Fax | 352-371-4865
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Provider Business Mailing Address
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Address Line | 5528 NW 43RD ST
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City | GAINESVILLE
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State | FL
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Zip | 32653-3301
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Country | US
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Telephone | 352-371-3604
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Fax | 352-371-4865
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME55647
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License Number State | FL
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