Provider Demographics
NPI:1396840476
Name:WORSHAM, RONDA M (RNMSNCS FNP)
Entity type:Individual
Prefix:MRS
First Name:RONDA
Middle Name:M
Last Name:WORSHAM
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Gender:F
Credentials:RNMSNCS FNP
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Mailing Address - Street 1:100B MALLARD SUNRISE DR E
Mailing Address - Street 2:
Mailing Address - City:WESTMORELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37186-3251
Mailing Address - Country:US
Mailing Address - Phone:615-644-3000
Mailing Address - Fax:615-644-3076
Practice Address - Street 1:103 REDBUD DR STE E
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:TN
Practice Address - Zip Code:37148-9918
Practice Address - Country:US
Practice Address - Phone:615-325-1206
Practice Address - Fax:615-325-1245
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
TNAPN0000012147207Q00000X
TN12147363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MW1447223OtherDEA