Individual
KATHERINE LYNN WORSNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9241 PARK ROYAL DR, FORT MYERS, FL 33908-9204
(239) 984-9859
Mailing address
9241 PARK ROYAL DR, FORT MYERS, FL 33908-9204
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9110889
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103205372-0001
—
PA
01
—
P01223433
RR MEDICARE
PA
Enumeration date
10/17/2007
Last updated
12/10/2024
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