Provider Demographics
NPI:1992560007
Name:WORSLEY, TANIECE ALFIA
Entity type:Individual
Prefix:
First Name:TANIECE
Middle Name:ALFIA
Last Name:WORSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 KENT PL
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-0768
Mailing Address - Country:US
Mailing Address - Phone:757-436-0605
Mailing Address - Fax:833-449-5172
Practice Address - Street 1:809 KENT PL
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-0768
Practice Address - Country:US
Practice Address - Phone:757-436-0605
Practice Address - Fax:833-449-5172
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024189528363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health