Provider Demographics
NPI:1942272406
Name:WORBY, LAURA (FNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:WORBY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 IRVING ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-3417
Mailing Address - Country:US
Mailing Address - Phone:202-529-6193
Mailing Address - Fax:
Practice Address - Street 1:2250 CHAMPLAIN ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2618
Practice Address - Country:US
Practice Address - Phone:202-232-9022
Practice Address - Fax:202-232-8494
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN56098363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC035964300Medicaid
DC035964300Medicaid
OOB227C10Medicare ID - Type Unspecified