Provider Demographics
NPI:1689320046
Name:ORANGE, MONICA N
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:N
Last Name:ORANGE
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 1:398 W BAGLEY RD STE 20J
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-1312
Mailing Address - Country:US
Mailing Address - Phone:440-230-1030
Mailing Address - Fax:
Practice Address - Street 1:398 W BAGLEY RD STE 20J
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:OH
Practice Address - Zip Code:44017-1312
Practice Address - Country:US
Practice Address - Phone:440-230-1030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
OH0139965146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No251E00000XAgenciesHome Health