Provider Demographics
NPI:1205312915
Name:WORELDS, JARVIS EARL (PRESTIGE HOME HEALTH)
Entity type:Individual
Prefix:MR
First Name:JARVIS
Middle Name:EARL
Last Name:WORELDS
Suffix:
Gender:M
Credentials:PRESTIGE HOME HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:9
Mailing Address - Street 2:2514 MARSHALL AVENUE
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23607
Mailing Address - Country:US
Mailing Address - Phone:757-952-9564
Mailing Address - Fax:
Practice Address - Street 1:958 13TH STREET
Practice Address - Street 2:
Practice Address - City:NEWPORT. NEWS
Practice Address - State:VA
Practice Address - Zip Code:23607-2360
Practice Address - Country:US
Practice Address - Phone:757-952-9564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA15083165972278H0200X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No2278H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedHome Health