Worthen, Russell G
Worthen, Russell G is an individual health care provider with primary practice located at 1000 E 100 N , Payson UT 84651-1600. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Worthen, Russell G can be contacted via phone (800) 748-4868.Contact Information
Primary practice address
1000 E 100 N
Payson UT 84651-1600
Phone: (800) 748-4868
Fax: (801) 733-5872
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 361659-4406 | Utah |
Profile Details
| NPI number | 1760586234 |
|---|---|
| LBN Legal business name | Worthen, Russell G |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 12th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760586234 | NPPES |
| Utah | Other | 107043317101 | IHC |
| Utah | Other | 67790 | IHC |
| Utah | Other | QMP000003333387 | IHC |
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