Provider Demographics
NPI:1417375692
Name:WORSLEY, JAMIE CLARE (DO)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:CLARE
Last Name:WORSLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JAMIE
Other - Middle Name:CLARE
Other - Last Name:CICCARELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:7250 PARKWAY DR
Mailing Address - Street 2:STE 500
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1343
Mailing Address - Country:US
Mailing Address - Phone:443-949-0814
Mailing Address - Fax:443-949-0825
Practice Address - Street 1:16605 KENDLE RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:MD
Practice Address - Zip Code:21795
Practice Address - Country:US
Practice Address - Phone:301-223-1241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDH0082811207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program