Provider Demographics
NPI:1568493385
Name:ORIS, JEANNE SUSAN (APRN)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:SUSAN
Last Name:ORIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MULE RD
Mailing Address - Street 2:SUITE E6
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5043
Mailing Address - Country:US
Mailing Address - Phone:732-505-5050
Mailing Address - Fax:732-505-9979
Practice Address - Street 1:9 MULE RD
Practice Address - Street 2:SUITE E6
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5043
Practice Address - Country:US
Practice Address - Phone:732-505-5050
Practice Address - Fax:732-341-5644
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN05919400363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223373283OtherTAX ID
NJS53205Medicare UPIN
NJ223373283OtherTAX ID