Provider Demographics
NPI:1558515932
Name:WORDEN, PATRICIA JO (MPT)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:JO
Last Name:WORDEN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18101 R PLZ
Mailing Address - Street 2:SUITE 106
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-1928
Mailing Address - Country:US
Mailing Address - Phone:402-933-8333
Mailing Address - Fax:402-933-4755
Practice Address - Street 1:18101 R PLZ
Practice Address - Street 2:SUITE 106
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68135-1928
Practice Address - Country:US
Practice Address - Phone:402-933-8333
Practice Address - Fax:402-933-4755
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1253225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist