Provider Demographics
NPI:1912712076
Name:WORRELL, DAVID W SR
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:WORRELL
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 ROSS AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-4000
Mailing Address - Country:US
Mailing Address - Phone:402-831-1469
Mailing Address - Fax:
Practice Address - Street 1:1012 ROSS AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-4000
Practice Address - Country:US
Practice Address - Phone:402-831-1469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion