Provider Demographics
NPI:1639256860
Name:ORR, GREGG CHEATHAM (CRNP)
Entity Type:Individual
Prefix:MR
First Name:GREGG
Middle Name:CHEATHAM
Last Name:ORR
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 NORTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-1406
Mailing Address - Country:US
Mailing Address - Phone:724-864-3510
Mailing Address - Fax:
Practice Address - Street 1:2080 NORTHVIEW DR
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-1406
Practice Address - Country:US
Practice Address - Phone:724-864-3510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009066363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health