Provider Demographics
NPI:1437434230
Name:ORR, JESSICA ROSS
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ROSS
Last Name:ORR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8850 LIMNOL ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-8721
Mailing Address - Country:US
Mailing Address - Phone:775-962-1223
Mailing Address - Fax:
Practice Address - Street 1:4408 CLEARWOOD DR
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-6363
Practice Address - Country:US
Practice Address - Phone:775-229-6826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV103R00000X172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker