Provider Demographics
NPI:1548792781
Name:ORLICH, SHAYNA M (NP)
Entity Type:Individual
Prefix:
First Name:SHAYNA
Middle Name:M
Last Name:ORLICH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 EXPLORER ST
Mailing Address - Street 2:
Mailing Address - City:GWINN
Mailing Address - State:MI
Mailing Address - Zip Code:49841-2813
Mailing Address - Country:US
Mailing Address - Phone:906-346-4924
Mailing Address - Fax:906-346-6474
Practice Address - Street 1:135 E M35
Practice Address - Street 2:
Practice Address - City:GWINN
Practice Address - State:MI
Practice Address - Zip Code:49841
Practice Address - Country:US
Practice Address - Phone:906-346-9275
Practice Address - Fax:906-346-5616
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704290399363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care