MEDICARE: JANE M. WORLEY APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0808X	Psychiatric/Mental Health Registered Nurse	026.0022351	VT
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	101.0022351	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881682516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE M. WORLEY APRN

Provider Business Mailing Address
First Line	:	PO BOX 1304
Second Line	:
City	:	MANCHESTER CENTER
State	:	VT
Zip	:	05255-1304
Country	:	US
Telephone Number	:	802-430-1176
Fax Number	:	949-430-1176

Provider Business Practice Location Address
First Line	:	19 GREEN MOUNTAIN ROAD
Second Line	:
City	:	MANCHESTER CENTER
State	:	VT
Zip	:	05255-1241
Country	:	US
Telephone Number	:	802-430-1176
Fax Number	:	949-430-1176

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	07/12/2019

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