Provider Demographics
NPI:1790046225
Name:WORSLEY, MIKHAEL
Entity Type:Individual
Prefix:
First Name:MIKHAEL
Middle Name:
Last Name:WORSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4119 APPLEGATE CT
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-3055
Mailing Address - Country:US
Mailing Address - Phone:202-350-7150
Mailing Address - Fax:
Practice Address - Street 1:4119 APPLEGATE CT
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-3055
Practice Address - Country:US
Practice Address - Phone:202-350-7150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide