Provider Demographics
NPI:1245067271
Name:WORDEN, KERSEE JO BURDETTE (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:KERSEE JO
Middle Name:BURDETTE
Last Name:WORDEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 EDGINGTON DR
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2915
Mailing Address - Country:US
Mailing Address - Phone:615-609-5726
Mailing Address - Fax:
Practice Address - Street 1:1445 E 10TH ST
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2017
Practice Address - Country:US
Practice Address - Phone:931-372-2567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8142225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist