Provider Demographics
NPI:1831724228
Name:WORDEN, MARGUEDY PATRICIA
Entity type:Individual
Prefix:
First Name:MARGUEDY
Middle Name:PATRICIA
Last Name:WORDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 EKLUND CT
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55057-1381
Mailing Address - Country:US
Mailing Address - Phone:507-271-7693
Mailing Address - Fax:
Practice Address - Street 1:14955 GALAXIE AVE
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-4519
Practice Address - Country:US
Practice Address - Phone:952-891-7509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker