Rebecca Dianna Worsham, CRNP
Individual provider Active NPI Family Nurse Practitioner · Laceys Spring, AL
NPI 1962564203 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1962564203
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 1-057030 (AL)
- Practice address
- 4258 Highway 231 Ste 5
Laceys Spring, AL 35754-6444 - Phone
- (256) 498-5770
- Fax
- (256) 498-5799
- NPI assigned
- Dec 14, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081016000505 | AL | Practitioner - Nurse Practitioner | 5991863128 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vivian Nell Hannon | Current |
Accepting new patients | |
| Vivian N Hannon | Family | Current | Accepting new patients |
| Vivian N Hannon | Family | Current |
Accepting new patients |
Locations
1241 Blount Ave
Guntersville, AL 35976
Phone (256) 582-6377
4258 Highway 231
Ste 5
Laceys Spring, AL 35754
Phone (256) 498-5770
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1-057030 | AL | Yes |
Addresses
Primary practice location
4258 Highway 231 Ste 5
Laceys Spring, AL 35754-6444
Mailing address
4258 Highway 231 Ste 5
Laceys Spring, AL 35754-6444
Phone (256) 498-5770
Other providers in Laceys Spring, AL
All providers in Laceys Spring, AL · Family Nurse Practitioner in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.