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General NPI Number Information
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NPI Number | 1811296890
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Entity Type | Individual
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Provider Name | ELIZABETH ERIN WORTHLEY PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/16/2011
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 2331 FRANKLIN RD SW
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City | ROANOKE
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State | VA
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Zip | 24014-1111
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Country | US
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Telephone | 540-981-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 5720 RALSTON ST STE 200
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City | VENTURA
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State | CA
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Zip | 93003-7844
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Country | US
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Telephone | 805-804-4168
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Fax | 805-830-1177
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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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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110004376
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License Number State | VA
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