Doctor Name: | FRASER RAYMOND WORTH |
NPI Number: | 1407205479 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPN |
License Number: | 4703093222 |
Business Practice Address: | 4222 Wellington Jackson, MI - 492017182 |
Business Phone Number: | 5177963024 |
Business Fax Number: | |
Mailing Address: | 4222 Wellington, JACKSON |
State: | MI |
Postal Code: | 492017182 |
Phone Number: | 5177963024 |
Fax Number: | |
NPI Enumeration Date: | 06/09/2016 |
NPI Last Update Date: | 06/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | 4703093222 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |