Provider Demographics
NPI:1578881520
Name:WORTHINGTON, LITA MARIE (RNC,RNP)
Entity Type:Individual
Prefix:MRS
First Name:LITA
Middle Name:MARIE
Last Name:WORTHINGTON
Suffix:
Gender:F
Credentials:RNC,RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 UNIVERSITY CIR
Mailing Address - Street 2:STUDENT HEALTH CENTER
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-3200
Mailing Address - Country:US
Mailing Address - Phone:209-667-3396
Mailing Address - Fax:209-667-3195
Practice Address - Street 1:1 UNIVERSITY CIR
Practice Address - Street 2:STUDENT HEALTH CENTER
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-3200
Practice Address - Country:US
Practice Address - Phone:209-667-3396
Practice Address - Fax:209-667-3195
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA328488363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health