Provider Demographics
NPI:1083998579
Name:ORIGA, ROSE ADAKU (ARNP)
Entity Type:Individual
Prefix:MS
First Name:ROSE
Middle Name:ADAKU
Last Name:ORIGA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 CYPRESS COVE CT
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32310-6355
Mailing Address - Country:US
Mailing Address - Phone:850-575-1910
Mailing Address - Fax:
Practice Address - Street 1:438 W BREVARD ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-1004
Practice Address - Country:US
Practice Address - Phone:850-224-2469
Practice Address - Fax:850-224-1139
Is Sole Proprietor?:No
Enumeration Date:2011-10-04
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3088492363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1083998579Medicaid