Provider Demographics
NPI:1124535554
Name:WORRELL-SPRINGER, PAMELA CECLIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:CECLIA
Last Name:WORRELL-SPRINGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:WORRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:188-19 104TH AVE
Mailing Address - Street 2:
Mailing Address - City:ST. ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412
Mailing Address - Country:US
Mailing Address - Phone:718-406-2531
Mailing Address - Fax:
Practice Address - Street 1:188-19 104TH AVE
Practice Address - Street 2:
Practice Address - City:ST. ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412
Practice Address - Country:US
Practice Address - Phone:718-406-2531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY506730163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management