Provider Demographics
NPI:1215725452
Name:WORTHINGTON, QUAYA MARLEANA (LPN)
Entity type:Individual
Prefix:
First Name:QUAYA
Middle Name:MARLEANA
Last Name:WORTHINGTON
Suffix:
Gender:
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2218 N MARSHALL ST APT C
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19133-2160
Mailing Address - Country:US
Mailing Address - Phone:484-201-9602
Mailing Address - Fax:
Practice Address - Street 1:2218 N MARSHALL ST APT C
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-2160
Practice Address - Country:US
Practice Address - Phone:484-201-9602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN321546164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse