Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 2553 | AZ |
NPI | 1427067933 |
---|---|
Provider Name | Katherine A Worden |
First Address | Glendale, AZ 85308-6813 |
Second Address | Glendale, AZ 85308-6500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 01/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
045189 | (05) | AZ |
E88395 | (02) | AZ |