Individual
AUDRA WORTHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP-PMH
Contact information
Practice address
309 E PATRICK ST, FREDERICK, MD 21701-6792
(240) 310-9961
Mailing address
250 ANTIETAM DR, FALLING WATERS, WV 25419-4880
(240) 310-9961
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R220300
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
666181500
—
MD
Enumeration date
09/24/2020
Last updated
10/06/2021
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