Provider Demographics
NPI:1831585942
Name:WORSENA, CRYSTAL RENEE (DO)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:RENEE
Last Name:WORSENA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 JUNGERMANN CIR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1637
Mailing Address - Country:US
Mailing Address - Phone:636-916-7060
Mailing Address - Fax:
Practice Address - Street 1:70 JUNGERMANN CIR STE 300
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1637
Practice Address - Country:US
Practice Address - Phone:636-916-7060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01022089352084N0400X
TN59782084N0400X
MO20200196492084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology