Provider Demographics
NPI:1033191721
Name:ORR, JENNIFER WELLS (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:WELLS
Last Name:ORR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4251 ARENDELL ST
Mailing Address - Street 2:STE C
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2869
Mailing Address - Country:US
Mailing Address - Phone:252-222-0660
Mailing Address - Fax:252-222-0663
Practice Address - Street 1:4251 ARENDELL ST
Practice Address - Street 2:STE C
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2869
Practice Address - Country:US
Practice Address - Phone:252-222-0660
Practice Address - Fax:252-222-0663
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-17
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9701092207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891063RMedicaid
NC2242378Medicare ID - Type Unspecified
NC891063RMedicaid