Provider Demographics
NPI:1477519924
Name:WORF, TERRI (ARNP)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:WORF
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 N MAIN ST
Mailing Address - Street 2:P O BOX 1133
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5400
Mailing Address - Country:US
Mailing Address - Phone:620-276-8201
Mailing Address - Fax:620-275-0712
Practice Address - Street 1:911 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5400
Practice Address - Country:US
Practice Address - Phone:620-276-8201
Practice Address - Fax:620-275-0712
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-64331-010363L00000X
KS45394363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100088530BMedicaid
KS100088530BMedicaid