Provider Demographics
NPI:1356005896
Name:ORR, PETER (DNP, RN)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:ORR
Suffix:
Gender:M
Credentials:DNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8030 HUMPHREY HILL DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44077-8738
Mailing Address - Country:US
Mailing Address - Phone:619-884-3736
Mailing Address - Fax:
Practice Address - Street 1:1701 MENTOR AVE STE 10
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-1459
Practice Address - Country:US
Practice Address - Phone:440-391-1308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH292860163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse