Provider Demographics
NPI:1235623034
Name:ORR, REBECCA MICHELLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:MICHELLE
Last Name:ORR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:MICHELLE
Other - Last Name:SARKOZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:10 CHALLENGER CT
Mailing Address - Street 2:
Mailing Address - City:EDWARDS
Mailing Address - State:CA
Mailing Address - Zip Code:93523-2601
Mailing Address - Country:US
Mailing Address - Phone:231-598-1366
Mailing Address - Fax:
Practice Address - Street 1:10 CHALLENGER CT
Practice Address - Street 2:
Practice Address - City:EDWARDS
Practice Address - State:CA
Practice Address - Zip Code:93523-2601
Practice Address - Country:US
Practice Address - Phone:231-598-1366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY019507183500000X
MI5302042320183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist