Provider Demographics
NPI:1851775654
Name:WORSTER, ELIZABETH (CRNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:WORSTER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:BETHANN
Other - Middle Name:
Other - Last Name:WORSTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:34TH STREET AND CIVIC CENTER BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-590-1000
Mailing Address - Fax:
Practice Address - Street 1:34TH STREET AND CIVIC CENTER BOULEVARD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-590-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014943363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics