Provider Demographics
NPI:1386118487
Name:WORSHIP, CEMARA (LPN)
Entity type:Individual
Prefix:MRS
First Name:CEMARA
Middle Name:
Last Name:WORSHIP
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:CEMARA
Other - Middle Name:
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25485 TUNGSTEN RD
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-2727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25485 TUNGSTEN RD
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-2727
Practice Address - Country:US
Practice Address - Phone:216-703-4913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH166660164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty