Provider Demographics
NPI:1437624301
Name:WORTHEN, WYLENE SATCHER (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:WYLENE
Middle Name:SATCHER
Last Name:WORTHEN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 SWEETGUM DR NE
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-9358
Mailing Address - Country:US
Mailing Address - Phone:478-456-9438
Mailing Address - Fax:
Practice Address - Street 1:1800 N RIDGE DR STE 1
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-2258
Practice Address - Country:US
Practice Address - Phone:478-456-9438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care