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General NPI Number Information
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NPI Number | 1831585942
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Entity Type | Individual
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Provider Name | CRYSTAL RENEE WORSENA DO
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Gender | Female
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Dates
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Enumeration Date | 04/15/2015
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 70 JUNGERMANN CIR STE 300
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City | SAINT PETERS
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State | MO
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Zip | 63376-1637
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Country | US
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Telephone | 636-916-7060
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Fax |
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Provider Business Mailing Address
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Address Line | 70 JUNGERMANN CIR STE 300
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City | SAINT PETERS
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State | MO
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Zip | 63376-1637
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Country | US
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Telephone | 636-916-7060
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2024-03090
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 5978
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2020019649
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 0102208935
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | OP7030005
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License Number State | WA
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Taxonomy #6
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | DO227150
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License Number State | OR
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