Provider Demographics
NPI:1528660149
Name:WORLEY, DAWN MARIE
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:WORLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:O'SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6419 WEBSTER PIKE
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WV
Mailing Address - Zip Code:26354-7620
Mailing Address - Country:US
Mailing Address - Phone:434-242-0131
Mailing Address - Fax:
Practice Address - Street 1:6419 WEBSTER PIKE
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WV
Practice Address - Zip Code:26354-7620
Practice Address - Country:US
Practice Address - Phone:434-242-0131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant